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EMPLOYMENT APPLICATION
POSITION(S) DESIRED:
Last Name First Name Middle Initial/name
Preferred Name/Nickname
Street Address City, State, Zip Code Email Address
Home Phone Number Work Phone Number Cell Phone or Pager Number
Please mark the following that pertain to you:
Part Time Full Time Permanent Contract Temp to Hire
How did you hear about us? (*We pay referral fees*) Have you ever applied with DRS before?
Yes
No
Hourly Minimum Pay* Annual Minimum Pay*
$ per hour $ per year
 
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DIVERSIFIED RECRUITING SERVICES, LLC IS AN EQUAL OPPORTUNITY EMPLOYER

In addition to attaching your resume, please list your work experience below.

COMPANY POSITION SALARY DATES REASON FOR LEAVING (DO NOT LEAVE BLANK)

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