5/19/2012
Last four #'s
       
 
      
MTWTFSS
    
    
 
 
   
Name:
Address:
City:
State: Zip:
     
Name:
Address:
City:
State: Zip:
     
Name:
Address:
City:
State: Zip:
     
For each of the following I circled “YES” to, I will be given written disclosure forms for signature prior to the start of any assignment requiring pre-employment drug test, background checks, credit checks or DMV records. I understand that if I circled “NO” to pre-employment drug testing, background checks, credit checks or DMV records, this will not preclude me from contract, contract to hire or direct hire assignments where pre-employment drug testing, background checks, credit checks or DMV records are not required.
 YES, I do    NO I do not     wish to be considered for an assignment where pre-employment drug testing is required.
 YES, I do    NO I do not     wish to be considered for an assignment where background checks are required.
 YES, I do    NO I do not     wish to be considered for an assignment where DMV records are required.
I hereby authorize the Emerald Group, Inc., dba Emerald Staffing, Inc. to make such investigations and inquiries into my employment, educational history and other related matters, as may be necessary in arriving at an employment decision. I HEREBY release employers, schools, and other persons from all liability in responding to inquiries connected with my application and for employment and I specifically authorize the release of information by any schools, individuals, services, and other entities. I HEREBY AFFIRM: That all information given by me on this pre-employment application and this employee data and work history card is true and complete. If my answers are false or misleading, you have the right to dismiss me immediately. If selected for employment, I agree to provide documentation showing I am authorized to work in the United States of America. You may contact my former employers for references and release the information herein to your clients and insurance company. In the event of an “on the job” injury, I will submit to a post accident drug test. I will notify you when the assignment is ending and my availability for work.
SKILL CHECKLIST Please check all that apply.
TYPE OF WORK DESIRED
Temp Only
Temp to Hire
Direct Hire
PT Only

EDUCATION LEVEL
4 Year Degree
2 Year Degree
Trade School Medical
Trade School Dental
Trade School Clerical
Trade School Legal
Trade School Industrial

LANGUAGES
Fluent Chinese
Fluent French
Fluent Japanese
Fluent Russian
Fluent Spanish


INDUSTRY BACKGROUND
Advertising
Automotive
Architectural
Banking
Credit Union
Construction
Distribution
Engineering
Electronics
Food Industry
Finance
Outside Sales
Inside Sales
Human Resources
Hotel
Comm Lines Ins.
Personal Lines Ins.
Work Comp Claims Exp.
Auto Claims
Insurance
Legal Background
Marketing Background
Medical/Dental Background
Non-Profit
Mfg. Background
Public Accounting Background
Property Mgt. background
Real Estate Background
Retail Background
Communications Background
Transportation Background
Hospital Background
Industrial Sales
Title/Escrow
IT Background
Mortgage

HOSPITALITY
Food Server
Bartender
OLCC

GENERAL LABOR
Commercial Driver License
Forklift Certified
Forklift Experience
Warehouse
Shipping/Receiving
Computer Inventory
Physical Inventory
Landscape
Mechanic

MEDICAL
Pharmacy Tech
Medical Reception
Medical Billing
Medical Records/Scanning
Medical Transcription
Medical Lab Technician
Certified Medical Assistant
Certified Limited Xray
CPT Coding
ICD-9 Coding
CPR Certified
Phlebotomy
LEGAL
Lexis Nexus
FindLaw
AbacusLaw
Amicus
Practice Master
Para Legal

COMPUTER SKILLS
Microsoft Word
Microsoft Excel
Microsoft Powerpoint
Microsoft Access
Microsoft Project
Microsoft Outlook
Microsoft Outlook Express
Microsoft Publisher
Front Page
WordPerfect 5.1/Win
WordPerfect/DOS
Eudora
Lotus 4.0
Lotus Notes
Quattro Pro/Win
Freelance/Win
Filemaker Pro
Harvard Graphics/Win
Novell/Win
Persuasion/Win
AMI Pro/Win
dBase 5/Win
Win Fax
ACT 2.0/Win
Visio
Approach
FoxPro/Win
Goldmine/Win
Q&A/Win
Adobe/Win
Corel Draw/Win
Freehand/Win
PageMaker/Win
Quarkxpress/Win
Venura/Win
DOS
Windows
Web Design Software
Peoplesoft
BlackBaud/Raiser's Edge


CSR/ADMIN/CLERICAL SKILLS
Transcription/Dictation
Filing/Alpha
Filing/Numeric
Mail Room
Postage Machine
Inventory
Copy/Xerox
Faxing
Telemarketing
Supply Ordering
Order Desk
CSR
Admin. Asst.
Word Processing
Executive Assistant
Office Manager
Desktop Publishing
Sales Support/Asst
Legal Secretary/Asst
Statistical Typist
Dictaphone
Shorthand
Speedwriting
Construction Site Admin.
Type Under 30 wpm
30-40 wpm
45-60 wpm
60-80 wpm
80+ wpm
10 Key Sight
10 Key Touch
Alphanumeric DE
Scheduling/Calendaring

ACCOUNTING
Progressive Billing
F/C Bookkeeper
AP
AR
Collections
Purchasing
General Ledger
Job Costing
Auditing
Bank Reconciliation
Tax Preparation
Payroll
Construction Accounting
Construction Union Payroll
Construction Non-Union Payroll
Construction Multi-State Payroll

ACCOUNTING SOFTWARE
TimeMatters
TimeSlips
AS400
YARDI
MAS90
MAS200
Great Plains
Oracle
Horizon
JD Edwards
Macola
Mas90/2000
Paradox
Peachtree
Platinum
Quickbooks
Quicken
Solomon
Symphony
Timberline
Timberline Gold
La Certe
Creative Solutions
Bidwell
AccPac

MEDICAL SOFTWARE
Centricity
MYSIS
EMR
LYTEX
Medical Manager
Medisoft
Mediu
IDX
Telecom
Logician
Millbrook
UB-92
HCFA 1500

COMMUNICATIONS
Ans. 1-5 Lines
Ans. 5-10 Lines
Ans. 10-20 Lines
Ans. 20-50 Lines
Ans. 50+ Lines
Receptionist
1-25 Ext.
25-75 Ext.
75+ Ext.
Dispatching
Paging System
Switchboard
Voicemail

MORTGAGE/FINANCE/TITLE
Proof Operator
Bank Teller
Vault Teller
Member Services Rep
Loan Processor
Closer
Funder
Lytec
Calyx
DU/LP
Underwriter
Escrow Assistant
Doc Drawer
Series 7


Please list agencies as well as companies you are presently engaged in the interview process with:


Please schedule your interview online!

Yes,  I would like to schedule my interview.

Please choose a date between M - F
                                  What time of day would you like?
No thank you, I prefer to speak to someone before I schedule an appointment.