SYNERGY PRO MARKETING ONLINE APPLICATION
(All Required Fields have Bolded text preceeding)
Personal Information
How did you hear about us?
First Name:
Last Name:
Address:
City:
State:
Zip:
Day Phone:
Email Address:
Cell Phone:
Home Phone:
Age Category:
18-25 26-30 31-40 41-50 51-60 over 60

Education Information
Have you graduated High School?
Yes No
Have you graduated College?
Yes No

Position Information
Position Desired:
Have you ever applied with us before?
Yes No
Are you legally authorized to work in the United States?
Yes No
If hired, you will be required to submit proff of your identity and legal work authorization as a condition of employment.
Have you ever been convicted of a felony?
Yes No
Do you have any relatives working at Synergy Pro Consulting?
Yes No
Do you have any specific salary requirements?
Yes No
When can you start working?
What type of employment are you looking for?
Full Part
Please review our two Work Schedules below.
SCHEDULE #1

Monday Tuesday Wednesday Thursday Friday
9am- 12pm
3pm - 8pm		 9am- 12pm
3pm - 8pm		 9am- 12pm
3pm - 8pm		 12pm- 8pm 9am- 12pm
1pm -6pm

SCHEDULE #2

Monday Tuesday Wednesday Thursday Friday
12pm- 8pm 12pm- 8pm 12pm- 8pm 12pm- 8pm 9am- 12pm
1pm- 6pm

Do you have a conflict with either of these schedules?
Yes No
Do you have transportation to and from work?
Yes No

Previous Employers
EMPLOYER #1
Company Name:
Company City:
Company State:
Company Phone:
Company Fax:
Supervisor Name:
Your Job Title:
Dates Employed:
From-
To-
Your Salary:
Why did you leave?
EMPLOYER #2
Company Name:
Company City:
Company State:
Company Phone:
Company Fax:
Supervisor Name:
Your Job Title:
Dates Employed:
From-
To-
Your Salary:
Why did you leave?
EMPLOYER #3
Company Name:
Company City:
Company State:
Company Phone:
Company Fax:
Supervisor Name:
Your Job Title:
Dates Employed:
From-
To-
Your Salary:
Why did you leave?

Personal References
REFERENCE #1 INFORMATION
First Name:
Last Name:
City:
State:
Occupation:
Phone:
How they know you:
Years Known:
May we contact them?
Yes No
REFERENCE #2 INFORMATION
First Name:
Last Name:
City:
State:
Occupation:
Phone:
How they know you:
Years Known:
May we contact them?
Yes No

Contact Dates and Times
PREFERENCE #1 PREFERENCE #2
Day:
Time:
Day:
Time:


I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understant that false or misleading informationin my application or interview may result in my release