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Applicant Screening Form

Collects personal, family, employment, and reference details to evaluate a candidate before moving forward in the hiring process.

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Name of Applicant

Nombre

Apellido

Phone Number

Section

Position Name

Expected Yearly Salary ($)

Date Applied

Date Available to Start

Do you have at least 3 years of experience for the position you are applying for?

Yes No

How many years of work experience do you have?

0–1 years 1–3 years 3–5 years 5+ years

Do you have a valid driver's license?

Yes No

Have you ever been found guilty of or convicted of a crime?

Yes No

Have you initiated or participated in any violence at work?

Yes No

Are there any open or pending legal proceedings you are currently involved in?

Yes No

Do you know anyone currently working or who has worked for this company?

Yes No

Do you have pending job applications with other companies?

Yes No

The company does not tolerate drug use before or during shifts and will conduct drug testing as needed. Are you willing to comply?

Yes No

Our company does not tolerate employees working under the influence of alcohol. Are you willing to comply?

Yes No

Our company has restrictions on smoking. Are you willing to comply?

Yes No

Are you willing to work flexible hours (such as rotating shifts, night shifts, weekends, and holidays)?

Yes No

Are you willing to work overtime as required by the company's needs?

Yes No

Our company does not tolerate employees working under the influence of alcohol. Are you willing to comply?

Yes No

Please upload a profile photo and government-issued ID

Max 10 MB per file

I agree with the following statements

I agree

Date

Signature

Sign here

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