Employment Application

VSS considers applicants for all positions without regard to race, color, religion, sex, national origin, age, martial status, sexual orientation, the presence of a non-job-related medical condition, or handicap, or any other bias restricted by law. Applicants must be able to provide proof of citizenship, or immigration status and visa. We participate in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. This will only be done if and after a job offer is accepted, and you have completed the Form I-9. Applicants may be tested for illegal drugs.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Secondary Phone
Email*
Date of Birth
Month
Day
Year
Social Security Number*
Are you a citizen of the United States of America?*
Are you 18 years of age or older?*
Do you have a valid Driver’s License?*
Driver's License State of Issue*
Driver's License Expiration Date*
Month
Day
Year
Driver's License Number*
Driver's License Type*
What is your means of transportation to work?*
Have you ever filed an application with VSS before?*
If yes, when?*
Have you ever been employed by VSS before?*
If yes, when?*
On what date are you available to start work?*
Month
Day
Year
On average, how many hours per week do you expect to work for VSS?*

Education - High Scoool
High School*
High School City & State*
City State
Did you graduate High School?*
Graduation Year
High School GPA*
If no, do you have your G.E.D.?*
G.E.D. Award Date*
Month
Day
Year
Education - College
Undergraduate College/University
Undergraduate School Address
City State
Did you Graduate College?
College Graduation Year
Diploma/Degree*
College GPA*
Please describe course of study*
Education - Graduate Program
Graduate School Name
Graduate School City & State
City State
Did you earn a graduate Degree?
If yes, please describe*
Education - Professional/Trade School
Professional/Trade School Name
Professional/Trade School Name City & State
City State
Did you Graduate from Trade School?
Trade School Graduation Date
Month
Day
Year
Trade School Certification*
Trade School GPA*
Please Describe your Trade School Course of Study*
Education - Other
Any other education; specialty training, skills, second languages, software knowledge, etc.

Employment History
Are you currently employed?
If yes, may we contact your present employer?*
Are you currently or have you been a member of the armed forces?*
Which Branch?*
Please fill out your work history information. Start with your present or most recent employer, then the next most recent, and so on. We need 7 years of employment history. If you need to, please continue on the back of this page.
Employer 1
Employer 1 Name*
Start Date*
Month
Day
Year
End Date
Month
Day
Year
Address*
Street Address Address Line 2 City State ZIP Code
Email
Phone
Supervisor Name*
First Last
Job Title*
Reason for Leaving*
Employer 2
Employer 2 Name
Start Date
Month
Day
Year
End Date
Month
Day
Year
Address
Street Address Address Line 2 City State ZIP Code
Email
Phone
Supervisor Name
First Last
Job Title
Reason for Leaving
Employer 3
Employer 2 Name
Start Date
Month
Day
Year
End Date
Month
Day
Year
Address
Street Address Address Line 2 City State ZIP Code
Email
Phone
Supervisor Name
First Last
Job Title
Reason for Leaving

References
Please list the name and contact information for 3 references. These individuals should not be related to you. Professional references are preferred.
Professional Reference #1
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*
Professional Reference #2
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*
Professional Reference #3
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*
Date
MM slash DD slash YYYY

DISCLAIMER: VSS will never share or sell your personal information ever – for any reason! We hold your privacy to be of the utmost importance.

Education - High Scoool