Noll Application

Select your Recruiter*
Contact

Ana Farmer // Recruiting Specialist
(402) 334-9200 x3431
afarmer@nolljobs.com
Contact

Ana Vargas // Recruiter
(402) 334-9200 x3435
avargas@nolljobs.com
Contact

Angela Hollingsworth // Application & Testing Coordinator
(402) 334-9200 x3441
ahollingsworth@nolljobs.com
Contact

Chris Victor // Staffing Manager
(402) 334-9200 x3443
cvictor@nolljobs.com
Contact

Christen Pegg // Recruiting Specialist
(402) 334-9200 x3419
cpegg@nolljobs.com
Contact

Danielle Griffin // Client & Employee Relations Manager
(402) 334-9200 x3424
dgriffin@nolljobs.com
Contact

Doug Misbach // CEO
(402) 334-9200 x3461
dmisbach@nolljobs.com
Contact

Emily Meints // Payroll Administrator
(402) 334-9200 x3433
emeints@nolljobs.com
Contact

Hannah Jack // Recruiting Specialist
(402) 334-9200 x3432
hjack@nolljobs.com
Contact

Jeff Campbell // Executive Recruiter
(402) 334-9200 x3416
jcampbell@nolljobs.com
Contact

Jessica Williams // Healthcare Recruiter
(402) 334-9200 x3428
jwilliams@nolljobs.com
Contact
Laura Kanan // Recruiting Specialist
(402) 334-9200 x3400
lkanan@nolljobs.com
Contact

Lorena Marrero // Account Executive
(402) 334-9200 x3413
lmarrero@nolljobs.com
Contact

Michelle Petersen // Healthcare HR Manager
(402) 334-9200 x3440
mpetersen@nolljobs.com
Contact

Missy Major-Weddle // Staffing Manager
(402) 334-9200 x3410
mmajorweddle@nolljobs.com
Contact

Paige McKern // Healthcare Recruiter
(402) 334-9200 x3442
pmckern@nolljobs.com
Contact

Stan Edelstein // Executive Recruiter
(402) 334-9200 x3415
sedelstein@nolljobs.com
Contact

Troy Shultz // Staffing Manager
(402) 334-9200 x3433
tshultz@nolljobs.com
Name*
First Last
Middle Initial*
Have you ever worked or attended school under a different name? If so, what name?
First Last

Home Phone
i.e. (402)999-9999
If you do not have a home phone number, please enter the best number at which to reach you
Cell Phone*
i.e. (402)999-9999
Business Phone
i.e. (402)999-9999
Email*
May we contact you at work?*
- Yes
- No
Alternative Contact Name
Alternative Contact Number
i.e. (402)999-9999
Authorized to work in the US?*
- Yes
- No

Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Permanent Address (if different)
Street Address City State / Province / Region ZIP / Postal Code Country

Position Desired
Desired Salary
Minimum Considered
Minimum Considered for Temporary work (if applicable)

Have you ever been convicted of a felony?*
- Yes
- No
Conviction:*

Applicants are not obligated to disclose a sealed juvenile record, which includes records of: an arrest, being taken into custody, a complaint, disposition of a case, diversion or adjudication of a criminal charge, or a sentence following conviction.
A conviction will not necessarily disqualify applicant from employment. Other factors will be considered such as the recency, severity, and pertinence of the conviction to the job.
Date:*
Have you ever been convicted of a misdemeanor?*
- Yes
- No
Conviction (Please list all charges, separated by a comma)*

Applicants are not obligated to disclose a sealed juvenile record, which includes records of: an arrest, being taken into custody, a complaint, disposition of a case, diversion or adjudication of a criminal charge, or a sentence following conviction.
A conviction will not necessarily disqualify applicant from employment. Other factors will be considered such as the recency, severity, and pertinence of the conviction to the job.
Date (Please list year(s), starting with most recent, separated by a comma)*

Are you registered with any other staffing companies?*
- Yes
- No
Which companies?
Do you have reliable transportation?*
- Yes
- No
Do your assignments need to be on a bus line?*
- Yes
- No
Can you work in a non-smoking environment?*
- Yes
- No

EDUCATION AND TRAINING

High School / GED
Name*
Address*
Did you graduate?*
- Yes
- No
What type of degree did you receive?*
- High School Diploma
- GED
- No Degree Completed
Continued Education

College or University
Name
Address
Number of years attended
Major/Minor
Did you graduate?
- Yes
- No
Type of Degree Received
Other Education

Special Training or Certifications
Have you received any other special training or earned any certifications?
- Yes
- No
Training/Certification Received
Expiration Date (If Applicable)
Training/Certification Received
Expiration Date (If Applicable)
Training/Certification Received
Expiration Date (If Applicable)
Training/Certification Received
Expiration Date (If Applicable)

List Three STRENGTHS:
1.)
2.)
3.)
List Three Areas of NEEDED IMPROVEMENT:
1.)
2.)
3.)

Describe your IDEAL JOB:
Industry
Job Functions
Are benefits important?
- Yes
- No
Please explain
Size of company
Office environment preference
- Professional
- Business Casual
- Casual
Any Other Details:

Interested in temporary employment?*
- Yes
- No
Criteria you would use for selecting a new employer:
1.)
2.)
3.)
4.)
Best time to interview
Please list any companies with which you have recently applied and/or companies you do not want Noll Human Resource Services to contact on your behalf:
Company 1
Company 2
Company 3
Company 4
Company 5
Company 6

REFERENCES:
List three persons whom you have worked with and whom can verify your work experience. Please let your references know they will be contacted.

Reference 1:
Name*
First Last
Where Employed
Relationship*
Phone*
Email
Reference 2:
Name*
First Last
Where Employed
Relationship*
Phone*
Email
Reference 3:
Name*
First Last
Where Employed
Relationship*
Phone*
Email

5 YEAR OCCUPATIONAL HISTORY:
Begin with current or most recent employer.

Employer 1:

(If you do not have a past or current employer, please enter N/A in the required fields below)
Company Name*
Type of Business
Address
Phone Number
Start Date*

mm/yyyy
End Date*

mm/yyyy
Starting Title*
Ending Title*
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position*
Reason For Leaving*
Employer 2:
Company Name
Type of Business
Address
Phone Number
Start Date

mm/yyyy
End Date

mm/yyyy
Starting Title
Ending Title
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position
Reason For Leaving
Employer 3:
Company Name
Type of Business
Address
Phone Number
Start Date

mm/yyyy
End Date

mm/yyyy
Starting Title
Ending Title
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position
Reason For Leaving
Employer 4:
Company Name
Type of Business
Address
Phone Number
Start Date

mm/yyyy
End Date

mm/yyyy
Starting Title
Ending Title
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position
Reason For Leaving
Employer 5:
Company Name
Type of Business
Address
Phone Number
Start Date

mm/yyyy
End Date

mm/yyyy
Starting Title
Ending Title
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position
Reason For Leaving
Employer 6:
Company Name
Type of Business
Address
Phone Number
Start Date

mm/yyyy
End Date

mm/yyyy
Starting Title
Ending Title
Name / Title of Supervisor
Starting Salary / Hourly Wage
Ending Salary / Hourly Wage
Describe Duties of Position
Reason For Leaving

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EDUCATION AND TRAINING

High School / GED

Continued Education

College or University

Other Education

Special Training or Certifications

List Three STRENGTHS:

List Three Areas of NEEDED IMPROVEMENT:

Describe your IDEAL JOB:

Criteria you would use for selecting a new employer:

REFERENCES:

Reference 1:

Reference 2:

Reference 3:

5 YEAR OCCUPATIONAL HISTORY:

Employer 1:

Employer 2:

Employer 3:

Employer 4:

Employer 5:

Employer 6: