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Personal Information

Name*

First Last

Email*

Contact Information

Cell Phone*

Home Phone

Current Address

Address*

Street Address City State Zip/ Postal Code

General Information

1.What type of work are you most interested in? (please list your first choice)*

2.If you would consider another option, what would be your second choice*

3. Upon hire, can you submit proof that you are legally authorized to work in the US*

Yes
No

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

4. What is your expected starting wage?*

5. If hired, when would you be able to start working?*

6. Have you ever worked at H2H Movers?*

Yes
No

7. How did you find about this job?*

Please specify source, if applicable:

Employment History (Current/Most Recent Employer)

Please provide your employment history. Starting with your most recent job, list the following for each of your lalst four employers

Name:Current/Most Recent Employer*

Address*

Street Address City County / State / Region ZIP / Postal Code

Telephone #*

Your title*

Date (From)*

Date (To)*

Hourly rate/Salary*

Supervisor's Name*

Your duties/job responsibilities*

Reason for leaving*

Employment History (Second Most Recent Employer)

Name: Employer 2*

Address*

Street Address City County / State / Region ZIP / Postal Code

Telephone #*

Your title*

Date (From)*

Date (To)*

Hourly rate/Salary (Starting)*

Hourly rate/Salary*

Supervisor's Name*

Your duties/job responsibilities*

Reason for leaving*

U.S. Equal Employment Opportunity/Affirmative Action Information Individuals seeking employment are considered without regards to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, veteran status, or sexual orientation. You are being given the opportunity to provide the following information in order to help us comply with federal and state Equal Employment Opportunity/Affirmative Action record keeping, reporting, and other legal requirements.

Please Note: Completion of this form is voluntary Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

Gender:

Male
Female
Declined to Self-Identify

Ethnicity/Race:

Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.
Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.
Declined to Self-Identify

Veteran Status:

Recently Separated Veteran
Armed Forces Service Medal Veteran
Other Protected Veteran
Not a Veteran
Declined to Self-Identify