Name and Address:

Home Phone #:

Cell Phone #:   

Work Phone #:

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Position Preferred

What position are you applying for?

You are looking for:

What wage are you expecting?

What date are you available to start?

What hours are you available to work? Please be specific, indicate Start/End

Do you expect to be with Newtown Answering Service for more than 1 year?   Yes No

How would you rate your computer skills? -- Select one-- Superior Above Average Average Below Average None

About how many words per minute can you type?

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Employment Status

Are you currently employed? -- Select one-- Yes No FT/PT? -- Select one-- Part Time Full Time N/A

If currently employed, do you plan on continuing that employment? -- Select one-- Yes No

During the past 5 years, how many different employers have you worked for? 1 2 3 4 5 6 7 8 9 10

Are you legally eligible to work in the United States? Yes No

Have you ever worked under, attended school under, or been known by a different name? Yes No

Have you ever been employed by Newtown Answering Service? Yes No

Have you ever been convicted of a felony? -- Select one-- Yes No

If yes, please explain

Please list your last 3 employments, beginning with the most recent

Please provide information about your highest level of education

Please provide 3 references who are neither related to you nor are previous employers

( Include Name, Phone #, and Relationship )

In a short essay, please tell us why you would be a great customer service representative.

By clicking "Submit" I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.  I understand that this application is not intended to be a contract for employment.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all the rules and regulations of Newtown Answering Service.