Employment Application

Labor Temps-THE STAFFING COMPANY
Employment Application

Applications are considered for all postions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or handicap.

First Name:
Middle Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
.
Social Security #:
Date of Birth:
Emergency Contact:
Education in # of Years:
Training/ Certification:
Drivers License No.:
Form of Transportation:(Car or Bus)
Availabilty	Mon
	Tues
	Wed
	Thurs
	Fri
	Sun
	Sat
Hobbies:
.
Employer # 1:
Address:
City/State/Zip:
Phone #:
Supervisors Name:
Job Title:
Reason for Leaving:
Dates of Employment: (From -To):
Salary or Wage:
Employer # 2:
Address:
City/State/Zip:
Phone#:
Supervisors Name:
Job Title:
Reason for Leaving:
Dates of Employment: (From-To):
Salary or Wage:
	Certification if Agreement – I certify that all answers given on this application are true and correct to the best of my knowledge. If not, it will be a basis for termination. I authorize this company to investigate my background and authorize them to release this information to other firms/persons. I understand that the duration of employment can vary along with the jobs to which I am assigned and that I can be terminated at any time. I understand that the pay rate can vary with each assignment. I agree to submit to drug or contagious disease tests upon request or as specified in the company’s substance abuse policy. I understand that my failure to report to the Labor Temps office for work on the next day after a job ends or from which misleading information given on my application or interview may result in termination. I understand that if any customer wishes to employ me full-time on their payroll I must complete 500 work hours through Labor Temps before they can employ me, or they must pay a “Buy-Out” fee to be determined by Labor Temps.
Comments:	Enter comments here!