Apply Online PersonalI'm interested in working in the*Scranton AreaAllentown/Lehigh ValleyWilkes Barre AreaSocial Security #*Full Name (First + Middle + Last)* Permanent Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell Phone*Email* Emergency Contact Name*Emergency Contact Number*Employment InterestsPosition(s) Desired or Area of Interest:* Production Worker Machine Operator Forklift Operator Warehouse Worker What is the minimum hourly pay rate that you need?*How did you hear about us?*Days You Can Work:* Monday - Friday Saturday & Sunday Monday-Sunday What shift do you prefer?*How will you get to work?*Employment HistoryGive employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.Dates Employed*FromTo Company Name (Most Recent)*Hourly Rate of Pay*Position*Reason for Leaving?Did you have another job before this one?*YesNoCompany Name (Second Most Recent)Dates EmployedFromTo Hourly Rate of PayPositionReason for Leaving?PhoneWould you like to list another previous job?YesNoCompany Name (Third Most Recent)Dates EmployedFromTo Hourly Rate of PayPositionReason for Leaving?Would you like to list a 4th job?YesNoCompany Name (Fourth Most Recent)Dates EmployedFromTo Hourly Rate of PayPositionReason for Leaving?Have you ever been convicted of a Misdemeanor or Felony?*YesNoIf yes, list dates, offenses, and disposition.Convictions are not an automatic disqualification from employment.Date of Birth* Date Format: MM slash DD slash YYYY I agree to a Criminal Background Check at the company's expense.*YesNoI agree to a Drug Screening at the company's expense.*YesNoAcknowledgementDynamic Staffing is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, age, protected veteran or disabled status, or genetic information. I authorize to Opt-In to receive company and employee related information via E-mail and SMS text messaging from DSI. I certify that the facts contained in this application are true & complete to the best of my knowledge & understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein & employers listed above to give you any information concerning my previous employment & any pertinent information they may have, personal or otherwise & release the company from all liability for any damage that may result from utilization of such information, I also understand & agree that representative of the company has authority to enter into any agreement for employment for any specified period of time, or make any agreement contrary to the foregoing, unless it is in writing & signed by an authorized company representative. I authorize Dynamic Staffing to investigate my background and qualifications for purposes of evaluating whether I am qualified for the position for which I am applying. I understand that Dynamic Staffing will utilize an outside firm or firms to assist it in checking such information, and I specifically authorize such an investigation by information services and outside entities of the company's choice. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application for employment will not be processed further.Digital Signature:Printing your First Name + Middle Initial + Last Name will act as your digital signature.Date Date Format: MM slash DD slash YYYY CommentsThis field is for validation purposes and should be left unchanged.