Questions? Call us at (614) 478-5448.
Application for Employment
LifeStart, Inc. is an Equal Opportunity Employer All sections/blanks on the application must be completed.
PERSONAL INFORMATION
AVAILABILITY SCHEDULE Please check the boxes below to indicate your availability for work on that day/time. Leave non-available days/times unchecked.
Click day to check entire day:
MIDNIGHT
MORNING
NOON
NIGHT
EDUCATIONAL INFORMATION Please complete all applicable fields. Leave non-applicable fields blank.
SPECIAL SKILLS & QUALIFICATIONS Summarize special job-related skills and qualifications acquired from employment or other experiences.
LIST PROFESSIONAL, TRADE, BUSINESS, OR CIVIC ACTIVITIES AND OFFICES HELD. ALSO LIST ALL VOLUNTARY TIME You may exclude memberships which would reveal sex, race, religion, national origin, ancestry, handicap, or other protected status.
REFERENCES Give name and telephone number of four references who have credentials, licenses, or are community leaders such as teachers, coaches, religious leaders, or club leaders.
EMPLOYMENT HISTORY Please give complete full-time and part-time employment record. Start with your present or most recent employer. Please explain any gaps in employment.
CRIMINAL AND DRIVING RECORD
Yes No (does not necessarily prohibit employment)
Yes No
STATEMENT OF AUTHENTICITY
I confirm that information provided on this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.
I understand that terms of my employment will be based on a positive background check and fingerprinting results from the Bureau of Criminal Investigation and Identification, reference checks, and driver safety records.
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