Job Application JOB APPLICATION Page 1 of 4CONTACTName*FirstLastEmail address*Phone (Primary)*Phone (Business)ADDRESSAddressAddress (Cont)City*StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZipELIGIBILITYAre you over the age of 18?*Yes, I am over the age of 18No, I am not over the age of 18You've selected no, Please state your date of birth*Citizenship*I am a United States CitizenI am a Lawful Permanent Resident of the United StatesI am a Non-United States Citizen Authorized to Work in the United StatesOtherAre you eligible for employment in the United States*Please selectYes, I am eligible for employment in the United StatesNo, I am NOT eligible for employment in the United StatesHas any time restriction been placed on your eligibility for employment in the U.S.No, I do not have any time restrictionsYes, I do have time restrictionsIf yes, what restrictionsPosition You Are Applying For (Job Title)*NextYou have selected that you are not eligible for employment in the United States. At this time Trotter Workforce's services are only available in the United States and it's territories. If you made a mistake please go back and change your answer. Thank you.I am eligible for employment in the United StatesBackDate Available to Start*Salary Requirement*Days Available to Work*MondayTuesdayWednesdayThursdayFridaySaturdaySundayAvailable Hours From:Available Hours Until:Reliable Transportation*Yes, I have reliable transportationNo, I do not have reliable transportationValid Driver's License*Yes I have a valid driver's licenseNo I do not have a valid driver's licenseBackground / Drug Screening Acknowledgment*I acknowledge that a background check and / or drug screening is potentially part of the job applicationBackNextPreviously Employed with TrotterHave you previously been employed with or applied to Trotter Workforce or it's subsidiaries*No, I have no prior relationship with Trotter WorkforceYes, I have been employed with Trotter Workforce in the pastYes, I have applied to Trotter Workforce in the pastDateReason for leaving if previously employedGeneral QuestionsCan you perform the duties of the position you are applying to with reasonable accomodation?*YesNoHave you ever been convicted of a felony?*NoYesIf so, please explain the felony in detailAre you willing to travel extended distance or relocate for a job position*NoYes (Within 20-49 Miles)Yes (Within 49-99 Miles)Yes (Within 100-250 Miles)Yes (More than 250 Miles)Voluntary Questions (All questions are optional)All questions in this section are voluntary and used for general and anonymous data on the demographic interest in careers with Trotter Management Services LLC [Trotter] and it's subsidiaries. Any information provided in this section will not be used to determine or influence employment opportunities with any division of Trotter or it's clients. Trotter strictly follows all EEOC rules and regulations.Have you ever served in the U.S. Armed ForcesYesNoBranch(es)ArmyNavyMarine CorpAir ForceCoast GuardNational GuardSpace ForceDates ServedProtected Veteran StatusNot a protected veteranDisabled VeteranOtherRaceAmerican Indian/Alaska NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderWhiteDecline to Respond Gender OrientationMaleFemaleOtherPrefer Not to SaySignature*I hereby confirm that all information is correct, up-to-date, and truthful to the best of my knowledge. By signing/typing my name I am giving Trotter Management Services LLC and it's subsidiaries the permission to review and fact-check the information provided in order to continue in the application and hiring process.BackSendThis field should be left blank
