Employment Application

We consider 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 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

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.
Reference #1
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*
Reference #2
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*
Reference #3
Name*
First Last
Email*
Phone*
Is this person a former employer?*
If no, what is their relationship to you?*

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