Employment - Online Application

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AFF, Inc.
Attn: HR
Job #_________
450 Shattuck Ave
Ste 401
Renton, WA 98055

Fax: (206) 624-8334

EEOE

Apply Online

INSTRUCTIONS
Answer each question completely, a red icon denotes a required value. All information will be held in confidence. If employed, the following answers will become a part of your permanent record.

Last, First Name & Middle Initial:		,
Street & Suite:
City, State & ZIP:
Email:
Phone (include area code):
Mobile/Cellular (include area code):
If hired, can you furnish proof that you are legally entitled to work in the U.S.?		Yes No
Please enter any relatives now employed by this company:
Job number/title applying for & desired salary:		# $
Do you have a valid driver license?		Yes No
Driver License State & Expiration Date:
List Skills, Training and Qualifications that would qualify you for the position(s) applying for:

EDUCATION

Highest grade completed in school:
Name of last school attended:
Street & Suite:
City, State & ZIP:
Date left school:
Courses of study, degree(s) and dates received:

PERSONAL (OPTIONAL)

Will you be able to work (select all that apply, use the Control key for Windows or Command key for Mac to click multiple items)?
List hobbies and interests:
Do you have the ability to perform job-related functions of the position(s) applied for?		Yes No
If you do not have the ability to perform job-related functions of the position(s) applied for, please describe how you will be able to get the job related functions performed:
Have you signed any agreements that include any provisions that could either prohibit employment with the us or restrict the terms and conditions of employment with our company?		Yes No
If you signed any agreements that include any provisions that could either prohibit employment or restrict the terms and conditions of employment, please describe:
Have you been convicted of a crime or court martial within the past seven (7) years?		Yes No
If you have been convicted of a crime or court martial within the past seven (7) years please describe:
May we contact your present employer?		Yes No

EMPLOYMENT HISTORY
Begin with your most recent job and account for every employment period, including all jobs full time, part time, short-term employment, self-employment and military service (please include at least the previous 7 years of employment):

Employer Name:
Street & Suite:
City, State & ZIP:
Salary:
Position:
Duties:
From - To (Month/Year):		-
Contact:
Phone (include area code):

Employer Name:
Street & Suite:
City, State & ZIP:
Salary:
Position:
Duties:
From - To (Month/Year):		-
Contact:
Phone (include area code):

Employer Name:
Street & Suite:
City, State & ZIP:
Salary:
Position:
Duties:
From - To (Month/Year):		-
Contact:
Phone (include area code):

Employer Name:
Street & Suite:
City, State & ZIP:
Salary:
Position:
Duties:
From (Month/Year):		-
Contact:
Phone (include area code):

Employer Name:
Street & Suite:
City, State & ZIP:
Salary:
Position:
Duties:
From (Month/Year):		-
Contact:
Phone (include area code):

PERSONAL REFERENCES

Name:
Street & Suite:
City, State & ZIP:
Phone (include area code):
Type & Length of Relationship:

Name:
Street & Suite:
City, State & ZIP:
Phone (include area code):
Type & Length of Relationship:

Name:
Street & Suite:
City, State & ZIP:
Phone (include area code):
Type & Length of Relationship:

Name:
Street & Suite:
City, State & ZIP:
Phone (include area code):
Type & Length of Relationship:

Name:
Street & Suite:
City, State & ZIP:
Phone (include area code):
Type & Length of Relationship:

RESUME (OPTIONAL)
You may include a text (only) version of your resume by pasting it in the field below. Please restrict to one printable page or less.

Resume:

AVAILABLITY AND ACKNOWLEDGEMENT

Date available for work:

I hereby certify that there are no willful misrepresentations in, omissions in or falsifications of the above statements and answers. I am aware that should investigation disclose misrepresentations, omissions or falsifications such disclosures will constitute grounds for immediate dismissal if I am employed by the Company and will automatically bar me from employment with the Company if I am not at that time an employee of the Company. I acknowledge and agree that any employment with this Company will be of an “at will nature” and will continue at the will of the Company and myself and may be terminated at any time for any reason by either party.

I Agree (by selecting the online "I Agree" option you confirm acceptance of the above statement)

Please note that the icon indicates a required value.