Position Applied For:  Email Address: 
Name:  Telephone Number: 
Present Address: 
City/State/Zip:  Desired Salary: 
Are you able at the time of employment to submit verification or your legal right to work in the U.S.? (Verification and completion of Form I-9 must be submitted no later than three business days after date to hire.)    Yes    No
If under the age of 18, can you produce the necessary work certificate at the time of employment?    Yes    No
Type of employment desired?    Full-time    Part-time (specify hours)
Are you willing to work overtime?    Yes    No Date on which you can start:
Have you ever applied to South East Total Service before?    Yes    No
Within the last ten (10) years, have you been convicted of a felony?    Yes    No

 School Name & Location:

 Course of Study:


 # of Years

 High School

     Yes    No    

     Yes    No    
 Trade or
 Post College
     Yes    No    
Employer Name: Address:
Phone: Employment Dates:
Job Title: Supervisor Name:
May we contact your previous employer?    Yes    No
Wages:    Start    Final Reason for Leaving:
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 Name:  Position:  Company:  Relationship:  Telephone #: