LESTER INC | Feedback Form

Personal Information

First Name

Last Name

Address

City

State

Zip

Phone

Date Available

Hours Available

Desired Pay

Have You Ever Been Employed by Lester?

Yes No

Past Location

When were you employed?

Have you ever been convicted of a felony?

Yes No

Felony Comments

Education

Last School Attended

School City

School State

Degree/Diploma Earned

Yes No

Number of years attended

Type of degree earned

Additional School/Certifications

Professional History 1

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Start Date

End Date

Position Title

Beginning Pay

Ending Pay

Supervisor Name

Supervisor Phone

Still Employed

Yes No

Reason for leaving

May we contact this employer

Yes No

Professional History 2

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Start Date

End Date

Position Title

Beginning Pay

Ending Pay

Supervisor Name

Supervisor Phone

Reason for leaving

May we contact this employer

Yes No

Professional History 3

Employer Name

Employer Address

Employer City

Employer State

Employer Zip

Start Date

End Date

Position Title

Beginning Pay

Ending Pay

Supervisor Name

Supervisor Phone

Reason for leaving

May we contact this employer

Yes No

Personal References 1

Name

Phone

Relationship

Years Known

Personal References 2

Name

Phone

Relationship

Years Known

Personal References 3

Name

Phone

Relationship

Years Known

Screening Question

Do you have a PC with Windows 7 or better?

Screening Question

Do you have exclusive use of that PC during daytime hours?

Screening Question

Do you have High Speed Internet?

Screening Question

If hired, are you willing to submit to a background check?

Screening Question

Are you legally allowed to work in the US ?

Screening Question

Do you have a quiet dedicated workspace where you can work free from distraction?

Screening Question

How many years computer experience do you have?

Screening Question

Do you have experience working from home?

Thank you for your interest but you do not have the minimum requirements for this position.

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