DHV LEGAL PLACEMENT SERVICES, INCORPORATED - "WE SAVE MONEY FOR YOU"
 
 
FOR THE CONTRACT ATTORNEY (1) - JOB APPLICATION FORMS

DHV Legal Placement Services, Incorporated ("DHV Legal Placement") considers all applicants for all positions without regard to race, color, creed, religion, national origin, gender, age, marital status, sexual orientation, military discharge status, non-job-related physical or mental disability, or any other legally protected status.

PERSONAL INFORMATION

Position Sought:
Date Available:
Salary Desired:
Per Hour
Per Week
Per Annum
First Name:
Last Name:
Middle Initial:
Address 1:
Address 2:
City:
State:
Postal Code:
Social Security Number:
E-Mail Address:
TELEPHONE NUMBERS

Home:
Work:
Mobile:
EMERGENCY CONTACT
Name:
Telephone Number:

EDUCATIONAL INFORMATION

College Name:
College Years Attended:
College Year Graduated:
College GPA (if, known):
Law School Name:
Law School Years Attended:
Law School Year Graduated:
Law School GPA (if, known):
Graduate School Name:
Graduate School Years Attended:
Graduate School Year Graduated:
Graduate School GPA (if, known):
Clerkship (Judicial):
Years Practicing Law:
1 to 5 Years
6 to 10 Years
10 Years or More

EMPLOYMENT HISTORY

Please, give us your full employment record. Start with your current or most recent employment. We will assume we have your permission to contact your former employer(s), unless you indicate to the contrary.

Name of Employer:
Address:
Address (City, State, Postal Code):
Duties:
Dates Worked (To/From):
Supervisor:
Telephone Number:
Salary:
Reason For Leaving:

Please, give us your full employment record. Start with your current or most recent employment. We will assume we have your permission to contact your former employer(s), unless you indicate to the contrary.

Name of Employer:
Address:
Address (City, State, Postal Code):
Duties:
Dates Worked (To/From):
Supervisor:
Telephone Number:
Salary:
Reason For Leaving:

Please, give us your full employment record. Start with your current or most recent employment. We will assume we have your permission to contact your former employer(s), unless you indicate to the contrary.

Name of Employer:
Address:
Address (City, State, Postal Code):
Duties:
Dates Worked (To/From):
Supervisor:
Telephone Number:
Salary:
Reason For Leaving:
EMERGENCY CONTACT FORM

Your Name:
Your Current Address:
Address 2:
City, State, Zip Code:
Your Home Telephone Number:
Your Mobile Telephone Number:
Your E-Mail Address:
IN CASE OF EMERGENCY, PLEASE NOTIFY (TWO CONTACTS, PLEASE)

First Contact
Name:
Relationship (e.g., Father, Mother, spouse, etc.):
Primary Telephone Number:
Please, Check One:
Work
Mobile
Home
Secondary Telephone Number:
Please, Check One:
Work
Mobile
Home
E-Mail Address:
Second Contact
Name:
Relationship (e.g., Father, Mother, Spouse, etc.):
Primary Telephone Number:
Please, Check One:
Work
Mobile
Home
Secondary Telephone Number:
Please, Check One:
Work
Mobile
Home
E-Mail Address:
Physician/Hospital Infomation
Physician's Name:
Physician's Telephone Number:
Preferred Hospital:
Other Relevant Information (if, any):
Date:
Signature:
Please, Print Your Name:

PROFESSIONAL REFERENCES

Please list three additional business references here if there are individuals, other than those listed in the employment history section, DHV can contact.

Name (1):
Address:
Telephone Number:
E-Mail Address:
How Do You Know This Person:
Name (2):
Address:
Telephone Number:
E-Mail Address:
How Do You Know This Person:
Name (3):
Address:
Telephone Number:
E-Mail Address:
How Do You Know This Person:

ADDITONAL INFORMATION

Are Your 18 Years of Age or Older?
Yes
No
Are You Legally Authorized to Work In the United States?
Yes
No
When Are You Available to Work?
Are You Available For Overtime?
Yes
No
What Type of Work Do You Want?
Temporary
Direct Hire
Temporary-To-Hire
Permanent
Have You Worked As a Contract Attorney Before?
Yes
No
Are You Available For Overtime?
Yes
No
How Did You Hear of DHVLPSI?
Friend
Employment Agency
Ad
School/College
Referral
Internet
Other
If Referral, Referral's Name:
Have You Applied For a Position or Worked With Us In The Past?
Yes
No
If Worked With DHVLPSI Before, When?
Have You Ever Been Discharged or Asked to Resign From a Position?
Yes
No
If You Have Been Discharged or Asked to Resign, Please Explain The Circumstances:
Have You Ever Been Convicted of A Crime (exclusing misdemeanors and traffic offenses)?
Yes
No
If You Have Been Convicted, Please Explain The Circumstances (a conviction does not necessarily disqualify an applicant for employment)::

PLEASE READ CAREFULLY BEFORE SIGNING:

The above information is true ad complete to the best of my knowledge. Should I be employed by DHV Legal Placement, any misrepresentation or false statements contained herein may be considered cause for immediate dismissal. DHV Legal Placement has my permission to obtain all necessary information from the professional licensing and education institutions,employers, and references I have listed, and I release all parties from any possible damages resulting from disclosing such information with or without prior notice to me. I understand that this application does not constitute an employment contract of any ikind, and employment is "at will." Should I be employed by DHV Legal Placement, I am free to resign at any time, with or without prior notice and DHV Legal Placement may transfer, reassign, suspend, demote, or teminate my employment at any time with or without cause and without prior notice. I understand that no agreement which is contrary to any of the matters stated above shall be effective unless it is in writing signed by the President of DHV Legal Placement.

Signature of Applicant:
Date:

TO BE COMPLETED BY INTERVIEWER (Please check appropriate boxes)

Academics (qualified)?
Yes
No
Legal Experience?
Yes
No
Temporary Experience?
Yes
No.
Attire (appropriate)?
1.
2.
3.
Personality:
1.
2.
3.
Flexibility?
Yes
No
Speech?
1.
2.
3.
Professionalism?
1.
2.
3.
Overall?
1.
2.
3.
Comments: