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Are you legally authorized to work in the USA? YesNo
Have you ever been convicted of a felony or misdemeanor crime? YesNo
If yes, state the basis for each conviction and the date of the conviction:
Are you able to perform the tasks according to the job description without accommodation? YesNo
If accommodation is needed, how would you perform the task and with what accommodation?
How did you hear about GEFA Staffing NewspaperTrade PublicationJob Fair/Open HouseEmployment AgencySocial MediaGEFA STaffing employeeother
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Please complete all appropriate items even if you have already provided us with a resume.
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Name of Current Supervisor
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If yes, what name?
Please list any other work-related information you think would be helpful to us in considering you for employment (such as foreign language competency, additional work experience, volunteer work, activities, accomplishments, publications, patents, thesis, etc.):
Please list three individuals with whom you have worked who were in a position to evaluate your performance.
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