A-1 Staffing Application - English-A-1 Staffing

A-1 Staffing Application - English

Please complete the form below. Thank you!

First name

Middle Name

Last name

Date of Birth

Gender

Male

Female

Prefer not to say

Social Security Number

Address

Phone Number

Can we text you?

Yes

Emergency Contact Name

Emergency Contact Phone Number

Optional: Are you fully vaccinated against Covid-19?

Yes

Available Shifts (Select all that apply)

First

Second

Third

Type of Employment (Select all that apply)

Full-Time

Part-Time

Do you have reliable transportation?

Yes

Additional Comments

1500

Optional: Upload Resume

Please read the information below. By signing, you agree to the rules and regulations as described.

I understand that this does not constitute a contractual agreement, and my employment is not bound by any guaranteed period under an employment contract.
My employment is “at-will”, which means that either the employer or the employee can terminate the employment relationship at any time, with or without cause, and with or without notice.
I will notify A-1 STAFFING immediately of any injuries, attendance issues, and termination of employment.
I will notify A-1 STAFFING of any change to my information, such as name, address, phone number, etc.
I will comply with all policies and procedures set forth by A-1 STAFFING and their client company where I am assigned work.
I give consent to A-1 STAFFING to any pre-employment screening such as Background Checks and Employment Verifications.
A-1 STAFFING is a Drug Free Workplace and my signature signifies compliance with all types of Drug Screening: pre-employment, random, reasonable suspicion and post-accident.
It is my responsibility to ensure I have clocked in and out correctly. If I believe there is an error in the hours recorded, I have 14 days to dispute the error. Any unpaid hours owed that extend past 30 days will be considered abandoned and may remain unpaid.
After working at least 30 hours a week for 60 days, I will be eligible for health insurance.

I understand that I should consult A-1 STAFFING about any questions regarding employment and our Rules and Regulations.

I understand that if my assignment ends, I am to contact A-1 STAFFING in the timeframe outlined above.

Today's Date

Your Signature