Capital Consultants, Inc., Staffing Services

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	Employment Pre-Application

Please fill out the following pre-application form and a Capital Consultants, Inc. associate will Email you information to complete your application if you should pre-qualify.

Choose Location

What area are you looking to apply for?

Personal Information

Name :		Home Phone # :
S.S.# :		Pager/Cell # :
Email :		Emergency # :

Previous Employment

Employer :		Length of Service :
Supervisor Name :		Phone # :

Employer :		Length of Service :
Supervisor Name :		Phone # :

Other Information

What method of transportation do you have?	Car	Bus	Walk
What method of transportation do you have?	Taxi	Other
If car, is it your own car?	Yes	No

What days are you available for work?	Every Day	Weekdays	Weekends
	Monday	Tuesday	Wednesday
	Thursday	Friday	Saturday
	Sunday


What job(s) are you applying for?
What is your minimum pay requirement?
What times are you available for work?

Are you currently working?	Yes	No
Do you have the information needed to complete a reference check form? (Dates, Addresses, and Phone numbers of your most recent employers.)	Yes	No
Will you consent to a criminal records check?	Yes	No
Are you willing to take a drug test?	Yes	No

Do you currently own a pair of steel-toed shoes?	Yes	No
If no, are you willing to purchase a pair (if required)?	Yes	No

Do you have one of the following, you need one from "A" and one from "B"?	Yes	No

A State Issued Drivers License State Issued I.D. Card Voters Registration Card School I.D. Card	B Social Security Card Birth Certificate

Employment Pre-Application