260.483.7085

CLERICAL

Name:*
Address:*
Phone:*
-
Other Phone :*
-
E-mail :*
I have used Tower Staffing, Inc. in the past :
Have you ever been convicted of a crime? :*
If yes, please explain below :
EMPLOYMENT HISTORY

Current or most recent employer:
Job title :
Start date:
End date:
Reason for leaving? :
Starting Salary :
Ending Salary :
Description of your duties :
Name of Supervisor :
Phone # for Supervisor :
-
May we contact them? :
Next most recent employer:
Job title:
Starting date:
Ending date:
Reason for leaving?:
Starting Salary:
Ending Salary:
Description of your duties:
Name of Supervisor:
Phone # for Supervisor:
-
May we contact them?:
Check any that pertain to your current work conditions :
NUMBER OF YEARS EXPERIENCE (NUMBERS ONLY, PLEASE)
BUSINESS BACKGROUNDS
Accounting:
Advertising/PR:
Aerospace:
Agriculture:
Airlines:
Architectural:
Automobile:
Avionics:
Chemical:
Communications:
Comp./Data Processing:
Construction:
Credit:
Credit Union:
Dental:
Education:
Electronics:
Fast Food:
Government:
Banking/Bank:
Banking/Credit:
Banking/Mortgage:
Banking/Sav. & Loan:
Insurance- General
Insurance- Casualty:
Insurance- Commercial:
Insurance- Health:
Insurance- Life:
Insurance- Medical:
Insurance- Medicare:
Insurance- Work Comp.:
Legal- General:
Legal- Civil:
Legal- Domestic:
Legal- Subrogation:
Engineering:
Freight:
Hotel Experience:
Printing & Publishing:
Property Management:
Purchasing:
Real Estate:
Religious:
Research & Dev.:
Restaurant:
Shipping/ Freight:
Transportation:
Trucking:
Telecommunications:
Video:
Legal- Criminal:
Labor Union:
Library:
Manufacturing:
Finance:
Food & Beverage:
Marketing:
Media (TV, Radio, etc.):
Medical:
Military:
Oil & Gas:
Personnel:
Photography:
Retail:
Sales Background:
Stock/Investment:
Service Industry:
Travel Agency:
Utilities:
Legal- Corporate:
Legal- Litigation:
Legal- Personal Injury:
Legal- Real Estate:
Journalism:
SECRETARY/TYPIST
Compose Letters:
Dictaphone Exp.-Heavy:
Dictaphone Exp.-Light:
Medical Transportation:
No Office Experience:
Secretary- Accounting:
Secretary- Cert. Legal:
Secretary- Cert. Medical:
Secretary- Cert. Pro.:
Secretary- Legal:
Secretary- Marketing:
Secretary- Medical:
Secretary- Purchasing:
Secretary- Sales:
Secretary- Shorthand:
Types- Bill of Landing:
Types- Correspondence:
Types- Invoices:
Secretary- Engineering:
Types- Purchase Orders:
Types- Reports:
Typewriter:
Typing- Light:
Typing- Statistical:
Typing- Straight Copy:
Typing- Technical:
Types- Lease Agreements:
Types- Legal Documents:
Types- Manuscripts:
Types- Medical Forms:
Types- Multiple Carbons:
Types- Numbers:
Types- Policies:
Types- Proposals/Quot.:
Types- Envelopes/Forms:
Types- Insurance Policies:
Secretary- Executive:
GENERAL CLERICAL
Calligraphy:
Claims Clerk:
Coding Clerk:
Copy Machine:
Copy Machine- Print Cen.:
Copy Machine- Blueprint:
Electronic Billing:
Filing- Alpha:
Filing- Numeric:
Filing System Design:
General Office Skills:
Insurance Claims Clerk:
Credit Bureau Exp.:
Ditto Machine:
Run Errands:
Stuffing/Folding Clerk:
Video Equip. Operator:
Good Handwriting:
Good Printing:
Good with Detail:
Inventory Clerk:
Light Labor Clerk:
Loan Clerk:
Lock Box Clerk:
Medical Claims Clerk:
Proofreader:
Recordkeeper:
COMPUTER SOFTWARE
ADP:
AS/400 System Software:
Desktop Pub./Graphics:
MAS 90 GL Acct. Soft.:
Microsoft Word:
PageMaker:
Peachtree:
Harvard Graphics/Win.:
Hewlett Packward WP:
Microsoft Excel:
Typesetting:
WordPerfect:
Microsoft Works:
Office Writer:
Lotus 1-2-3:
Paradox:
Microsoft PowerPoint:
Quicken:
Norton Utilities:
Novell:
PC DOS 5.0:
COMPUTER-RELATED
CRT- Alpha:
CRT- Numeric:
Microsoft Windows 3.0:
Mouse Experience:
CRT- Entry:
Keyboard 10-Key:
Macintosh Computer:
Proof Operator:
Programmer:
Laser Printer:
COMMUNICATIONS
E-Mail Communications:
Receptionist- Medical:
Telemarketing:
Fax Machine:
Receptionist- Relief:
Receptionist- Dental:
Receptionist- Full-Time:
Receptionist- General:
ACCOUNTING
Auditor:
Bank Teller:
BKKP-AP/Computer:
BKKP-AR/Computer:
BKKP-AR/Manual:
Budget Analysis:
Payroll- Hourly:
Payroll- Manual:
Payroll-26-100 Emp.:
Payroll->100 Emp.:
Taxes-Payroll:
Taxes-State Filings:
Cashier Accounting:
Cash Register:
Payroll- General:
Billing Clerk:
Postage Machine Oper.:
Proof Operator :
Spreadsheet Knowledge:
Taxes- Multistate Filings:
Uses 10-Key by Touch:
Accountant:
Accountant Clerk:
Cash Management:
Collections:
Credit :
Electronic Calculator:
Financial Analyst:
Fixed Assets Acct.:
Good with Numbers:
Inventory Accounting:
MAIL/STOCK ROOM
Bulk Mail Sorting:
Burster Machine Oper.:
Collator Operator:
Computer Inventory:
Warehouse Stock Room:
Expeditor:
Factory Stock Room:
Postal Regulations:
Retail Stock Room:
Folding Machine Oper.
Mail Clerk.
Mail-File Sorting:
Postage Machine Oper. :
MISCELLANEOUS OFFICE
Admitting Clerk:
Child Care Experience:
Customer Service:
Medical Assistant:
Emergency Med. Tech.:
Underwriter:
Nursing Assistant- Cert.:
Messenger/Delivery:
Dispatcher:
Drafting:
Management:
Sales- Inside:
Waiter/Waitress:
Notary:
One-Person Office:
Paralegal:
Public Relations:
Sales-Outside:
Supervisor:
Teacher:
Technical Writer:
Training & Development:
Travel Arrangements:
TERMS AND CONDITIONS 
"I understand that if I am offered and accept a job, the company reserves and retains the right to make such changes in the terms and conditions of my employment as the company determines to be necessary or appropriate."

"I understand and agree that my future employment is not for any guaranteed length of time and that both the company and I have the freedom to terminate the employment relationship whenever either chooses to do so."
APPLICANT'S AUTHORIZATION TO RELEASE INFORMATION
It is important that each item on this application is correctly and completely answered. False information, misrepresentation or omissions of act, with respect to any part of or item on this application, may be cause for rejection, or for dismissal if employed.

While processing my application, I authorize Tower and its Agents to contact schools, employers, references, and organizations to conduct a background investigation, and to obtain a credit report. I further authorize such persons to provide Tower and its Agents with all relevant information necessary to process my application.

By choosing "I Agree" and typing my Initials, I affirm that all statements made are true, and misrepresentation of facts will subject me to immediate rejection, or for dismissal if employed. I also consent to a controlled substance screening test and give my consent for all information obtained as a result of any medical examination and all other relevant medical information to be released to Tower and its Agents for the employer's use only.
I AGREE*
INITIALS : *