GCS LogoApplication for Employment

Please fill out the following form. When you hit the submit button after completing the following form we will receive your application.

Please check the center you are applying to work in:
Yuma, AZ Lancaster, OH Mt. Hope, WV Wheeling, WV
Fort Lauderdale, FL Pulaski, VA Summersville, WV Manila
Pittsfield, ME Kingsville, TX Saltville, VA
Salisbury, NC Odessa, TX Huntington, WV Any Location
Personal

Last Name:

First Name: Middle Initial: Date:
Is any additional information relative to a different name necessary to check your work record? If yes, explain.
Street Address: Home Phone:
City: State: Zip Code:
Have you ever been Employed with us? yes no
If yes, month and year?
Have you had an interview with us in the past 6 months? yes no
If yes, please list approximate dates:  
Position Desired: Date Available to Work:
Are you legally eligible for employment in the United States?
yes no 		Can you work weekends? yes no
Shift Preference: Day Night Any Part Time
Full Time
Have you ever been convicted of a felony? yes no
A conviction may not necessarily be a bar to employment.		 Are you at least 18 Years old? yes no
If you were referred by an employee, please list their name:
Education:
School Name and Location of School Course of Study Did you Graduate? Degree
High School:
yes no
College/Trade/Technical School:
 yes no
Graduate School:
yes no
Typing WPM: Have you previously worked with computers? If so, list applications:
Professional Licenses or Certifications:
Use this space to include any additional information which would be useful in considering you, including military, volunteer, or public service:

Employment

Employer 1
Company Name:
 Telephone Number:
Address
 Employed from :
To
Name of Supervisor
 Salary/hourly rate :
To
Job Title and duties:
Reason for leaving:
Employer 2
Company Name:
 Telephone Number:
Address
 Employed from :
To
Name of Supervisor
 Salary/hourly rate :
To
Job Title and duties:
Reason for leaving:
Employer 3
Company Name:
 Telephone Number:
Address
 Employed from :
To
Name of Supervisor
 Salary/hourly rate :
To
Job Title and duties:
Reason for leaving:
Indicate any employers you would like us not to contact (and reason).
References
Please list your references. (Or any friends or relatives that work for GCS.)
Name Location

I hereby certify that the information in this application is true and correct. I hereby authorize the Global Contact Services (GCS) to conduct a background inquiry which may include employer reference checks, consumer credit records, felony convictions, motor vehicle and other relevant reports. Furthermore, I release liability from GCS and its representatives for seeking such information as well as all other persons, corporations or organizations for furnishing such information. I understand that should I be employed by GCS, any misrepresentation of the facts as stated or implied on this application is sufficient cause for dismissal. Should I become employed, I agree to conform to the rules and regulations of the company and acknowledge that my employment and compensation can be terminated, with or without cause and with or without notice at any time and for any reason at the discretion of either myself or Global Contact Services.

Date:

Initials:

Since this is an electronic application your initials will be considered your signature until we can obtain a physical signature.