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Jump Start Screening Profile

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Personal Information
First Name*
Middle Name
Last Name*
Address*
Street Address City ZIP Code
Home Phone
Cell Phone
Email Address
Are you a veteran?*
- Yes
- No

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Job Information
What are your top three job preferences?
First Preference*
Second Preference
Third Preference
What shifts will you work?*
- Days
- Nights
- Evenings

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Are you legally authorized to work in the United States?*
- Yes
- No
Preferred Job Type*
- Full Time
- Part Time
- Temp
OK to contact present employer?*
- Yes
- No
If you want to create an employment web page, choose "yes" below:*
- Yes
- No
Employment Web Page details are found here (this link will open in a new tab).
Are you registered in Work-in-Texas?*
- Yes
- No
Please click the button below to register
(the form will open in a new tab)
Register

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Education / Training
Have you obtained a high school diploma or GED?*
- Yes
- No
High School Name and Location
Have you attended a college or university?
- Yes
- No
College or university
School Name and Location
Specialization
Diploma / Degree
Need to list more schools?
- Yes
- No
Second college or university
School Name and Location
Specialization
Diploma / Degree
Need to list more schools?
- Yes
- No
Third college or university
School Name and Location
Specialization
Diploma / Degree
Need to list more schools?
- Yes
- No
Fourth college or university
School Name and Location
Specialization
Diploma / Degree
Need to list more schools?
- Yes
- No
Fifth college or university
School Name and Location
Specialization
Diploma / Degree
Other Qualifications, Courses and Achievements
Please list any special activities, achievements, certificates, licenses or training courses
Other specific skills you have to offer

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Do you have a resume?*
- Yes
- No
Typing Speed
Equipment /Machinery Skills
- Computer
- 10-key calculator
- Copier
- Fax Machine
- Scanner
- Multi-line phone
- Recording equipment
- Video equipment
- Forklift
- Scissorlift
- Welding equipment
- Hand tools
- Drilling equipment
- Construction equip
- Electrical tools
- Automotive tools
- Other
Computer Software Skills
- Microsoft Word
- Microsoft Excel
- PowerPoint
- Outlook
- Adobe Illustrator
- Adobe Photoshop
- Filemaker Pro
- Lotus
- Pages
- Indesign
- Canvas
- Quark
- Hand Tools
- Quicken
- QuickBooks
- Print Shop
- Other
Please provide the extra information requested below:
Other Equipment*
Other Software*
On what days of the week are you able to work?*
How far are you willing to drive to work?*
Are you bondable?
- Yes
- No

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The following questions are intended to help us better understand your situation, in order for CJX to make a good fit with an employer.
How many children do you have needing day care assistance?
Do you have reliable day care?*
- Yes
- No
Do you have back-up day care?*
- Yes
- No
Do you have reliable transportation?*
- Yes
- No
Do you have any health issues?*
- Yes
- No
Please Explain*
Do you have any handicap, conditions or limitations on your physical ability to work?*
- Yes
- No
Please Explain*
Do you have a misdemeaner?*
- Yes
- No
How many years ago?*
Do you have a felony?*
- Yes
- No
How many years ago?*
Are you on probation?*
- Yes
- No
How many years are left?*
Can you pass a drug test?*
- Yes
- No
When was the last time you used?*
Sign this screening profile by checking the box below*
- I certify that the answers I have provided are true and correct.

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