Please fill in the following form and you will be contacted by Human Resources to schedule an interview.

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Personal Information

*First Name:	A value is required.
*Last Name:	A value is required.
*Phone Number:	A value is required.Invalid format.
Cell/Other Number:	Invalid format.
Email:	Invalid format.
Street Address:
City:
State:
Zipcode:

Application Details

Position:
Referral:
Location:	Illinois Ohio Kansas City
Start Date:	Invalid format.
Salary Requirement:
Employment Type:

Full-Time

Part-Time

Temporary

Seasonal

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Are You Under 18?YesNo
If so, do you have a work permit?Yes No
Have you ever worked for us before?Yes No
If yes, when and where? 
Are you U.S. Citizen?Yes No
If not, can you work in the U.S legally?Yes No List special skills or qualificiations:

Previous Employment

Dates of Employment: From		To:
Position(s) Held:
Firm:
Address:
Phone:	Invalid format.	Supervisor:
Title(s):
Starting Salary:		Ending Salary:
Reason for Leaving:
May we contact employer?	Yes No
Dates of Employment: From		To:
Position(s) Held:
Firm:
Address:
Phone:	Invalid format.	Supervisor:
Title(s):
Starting Salary:		Ending Salary:
Reason for Leaving:
May we contact employer?	Yes No
Dates of Employment: From		To:
Position(s) Held:
Firm:
Address:
Phone:	Invalid format.	Supervisor:
Title(s):
Starting Salary:		Ending Salary:
Reason for Leaving:
May we contact employer?	Yes No

I certify that my answers are true and complete to the best of my knowledge. I authorize G.S. Floor Designs, Inc. to make such investigations and inquiries of my personal, employment, educational, financial, and other related matters as may be necessary for an employment decision. I hereby release employers, schools, or individuals from all liability when responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

By submitting you are agreeing to these terms.