Submit Application
PPSI Employment Opportunities

All materials will be held in strict confidence.

Occupation:
Other:
Social Security Number:
Practice Areas:
FL Bar Number:
Date Admitted to Bar:
Other Bar Memberships:
Name (last, first, MI):
Address:
City:
Apt:
State:
Zip:
Home Phone:
Ext:
Work Phone:
Ext:
Fax:
E-mail:
Employment Desired:

Driver's License Information:

State: Number: Emergency Contact:
Name: Phone: Relationship:

Please list your work experience (Most recent first)

Company1: Company Address: Company Description:
Start Date: End Date: Position/Duties:
Salary: Bonus: Reason For Leaving:
Company2: Company Address: Company Description:
Start Date: End Date: Position/Duties:
Salary: Bonus: Reason For Leaving:
Company3: Company Address: Company Description:
Start Date: End Date: Position/Duties:
Salary: Bonus: Reason For Leaving:
Company4: Company Address: Company Description:
Start Date: End Date: Position/Duties:
Salary: Bonus: Reason For Leaving:

Relevant Education (List Two Highest):

Year:
College/School:
GPA:
Major:
Scale:
Degree:
Honors & Activities:
Year:
College/School:
GPA:
Major:
Scale:
Degree:
Honors & Activities:
Computer Skills/Languages:

Languages - Speak, Write, Read (Please specify skill level - Fluent, etc.):

Certifications (Identify type, certifying authority and date of certification):

Professional Associations (Identify association, date of admission and ID number):

Has disciplinary action (of any kind)ever been taken against you by any association?
If YES, please explain:

Have you ever been convicted of a felony, a misdemeanor resulting in imprisonment or in military court martial?
If YES, please explain:

Is it legal for you to work in this country?
Will you relocate?
Will you work in a smoking office?
How will you commute to work?
How did you hear about PPSI?
Other:
If Referral, who referred you?
Complete this section if you are looking for permanent employment:
Salary Minimum:
Will you relocate?
If yes, list preferences:
Where have you applied for employment over the past year?
Have you registered with PPSI before?
Approximate year:
Where:
Are you currently employed?
Does your employer know you are leaving?
Will you pay part of your relocation expense?
Complete this section if you are looking for temporary employment:
Minimum hourly rate:
When are you available to start an assignment?
Is there anything that will interfere with your work schedule... trips, illness, etc.?
If yes, please explain.
Will you work part time hours? If no, explain what hours:
Have you registered with PPSI before?
Approximate year:
Where:
Where have you worked on a temporary basis?
Where have you applied for temporary employment before?
Do you want your check mailed?
Do you temporarily have malpractice insurance?
Policy No.
Insurer:
Limits:
What equipment do you have at your disposal to perform legal services?
Are your legal services available on a regular basis?
Do you utilize an entity name when providing legal services to others?
Name:
EIN
REFERENCES
COMPANY
PERSON
TITLE
PHONE
CERTIFICATE OF APPLICANT (To Be Completed By All Applicants)
GENERAL: I understand that I will never be charged a fee by PPSI. I acknowledge that the use of this form, and my filling it out, does not indicate that any positions are open, nor does it obligate PPSI to further process my application. I certify as to the accuracy of the matters set forth herein and in any resume furnished to PPSI and understand that any misstatement of fact may cause me to be refused placement or to be discharged. I further understand that a contract will exist between PPSI and each client to whom I may be assigned or introduced, which will require the client to pay PPSI a fee in the event the client hires me directly or makes a referral which results in another organization hiring me. I agree to notify PPSI immediately should I be offered direct employment by a PPSI client or by another organization as a result of a referral by a PPSI client within one year after my introduction to the PPSI client or the last day of any assignment period, whichever is later.
REFERENCES: I hereby authorize PPSI to make such investigations and inquiries into my employment and educational history and other related matters as may be necessary in arriving at a placement decision. I hereby release employers, schools and other persons from all liability in responding to inquiries connected with my application and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities, listed by me in this form. Furthermore, I authorize PPSI to release any reference information it may obtain to it's clients who request such information for purposes of evaluating my credentials and qualifications. I understand that I have the right to request information about the nature and scope of the reference material PPSI obtains.
TEMPORARY PLACEMENT: If placed on a temporary basis by PPSI, I understand that I will be either an independent contractor or an employee of PPSI and not an employee of any PPSI client. If placed on a temporary basis by PPSI, I further understand that my placement with PPSI is not guaranteed for any specific time and may be terminated at any time for any reason. Since PPSI is a placement service and is not in the business of practicing law, I will not render any opinions, sign any documents or make any court appearances on behalf of PPSI. Additionally, I will not handle or transport cash, negotiable, or other valuables of a PPSI client without the written consent of PPSI.
Initial Here:

 
     
          
          
          
          
          

© 2005 Professional Placement Services, Inc.