Application For Employment

Full Legal Name (First, Middle, Last, Suffix) * Required

Current Address * Required

Preferred Phone Number * Required

Type of Phone Number Provided * Required

If you provided a cell phone, do you allow permission to receive text messages? Data rates may apply depending on your plan and carrier.

Yes

No

Email Address

Source (How did you hear about us?) * Required

If you were referred by someone who works with us, please indicate that person’s name below.

Are you over the age of 18? * Required

What position are you applying for or would you like to be considered for? * Required

If hired, can you provide proof of identity & authorization to work in the United States?

Do you require sponsorship to work with our company?

What shifts are you available for? * Required

First Shift

Second Shift

Third Shift

If hired, would you have reliable means of transportation to and from work?

How many hours a week are you available to work?

Are you seeking full time, part time, temporary or seasonal employment?

Can you perform the essential job functions of the desired position? * Required

If no, please describe the functions that can not be performed;

What days of the week are you available? * Required

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What is your highest level of education?

Did you receive a high school diploma?

Name of high school attended;

Please include city and state.

Person to notify in case of emergency; * Required

Relationship to you; * Required

Telephone number: * Required

Experience:

(1) Name of Employer * Required

Please give accurate and complete information. List your 3 most current employers starting with the most recent. Include self employment, part time work, military employment and any work performed on a volunteer basis. Account for any gaps in your employment. This section needs to be completed, even if you have a submitted a resume.

Address of Employer (Street, City & State)

Job Title * Required

Supervisor's Name

Phone Number

Reason for leaving? * Required

Start Date * Required

End Date * Required

May we contact this employer as an employment reference? * Required

Yes

No

Please include your job responsibilities below; * Required

(2) Name of Employer

Address of Employer (Street, City & State)

Job Title

Supervisor's Name

Phone Number

Please indicate your phone type:

Reason for leaving

Start date

End date

May we contact this employer for an employment reference?

Yes

No

Please include your job responsibilities below;

(3) Name of Employer

Address of Employer (Street, City & State)

Job Title

Supervisor's Name

Phone Number

Reason for Leaving

Start Date

End Date

May we contact this employer as an employment reference?

Yes

No

Please list your job responsibilities;

Skills & Qualifications

Microsoft Outlook/Email

Microsoft Office/Excel

Microsoft Word

Adobe Acrobat

Print/Scan

Virtual Meetings (Zoom, Teams)

Telephones

Publishing Programs

Social Media

General Labor

List any special training, experience, qualifications, or skills relevant to the position for which you are applying:

Customer Service

Payroll Processing

Leadership/Management

Accounts Payable/Receiveable

Human Resources

Accounting

Sales

Data Entry

Bilingual

Please read carefully and initial below each paragraph acknowledging your understanding.

I understand that the company operates as an At-Will employer, meaning that either the employee or the company may terminate the employment relationship at any time, with or without cause, and with or without notice. I further understand that no agreement contrary to this At-Will arrangement is valid unless it is made in writing and signed by the President of the company. No supervisor or representative of the company has the authority to make any implied or express agreements that conflict with this At-Will policy. * Required

Employee/Employer Acknowledgement * Required

Advantage Business Services is a staffing referral company that connects candidates with Employers Outsourcing, Inc., which will serve as the employer of record. If hired, you will receive your pay via a weekly pay card or direct deposit from Employers Outsourcing, Inc., based on the hours you worked. Any employment verifications, as well as requests for unemployment, disability, or workers' compensation benefits, will be directed to Employers Outsourcing, Inc. as your employer.

Payroll Deductions * Required

If hired, I authorize the company to make deductions from my paycheck for any errors in payroll, garnishments, and any overpayments made to me in error.

Substance Abuse Policy * Required

Any employee on duty or on company property who possesses, sells, receives, or is found to have detectable levels of illegal drugs, alcohol, or marijuana in their blood or urine that impair performance will be subject to immediate termination. In appropriate cases, the matter may be referred to law enforcement authorities. By entering the client worksite property, employees consent to inspections of their person, lockers, vehicles, or any other personal belongings. The company reserves the right to require drug, alcohol, and marijuana testing based on reasonable suspicion.

Reporting Discrimination & Harassment * Required

The company does not tolerate unlawful harassment or discrimination of any kind. If you are subjected to or witness any form of unlawful harassment or discrimination, including but not limited to harassment or discrimination based on race, sex, sexual orientation, pregnancy, age, religion, citizenship, color, veteran or military status, unfavorable military discharge, retaliation, national origin, ancestry, disability, or marital status, you are required to immediately contact Human Resources at 805-754-3122.

Accident/Injury Procedure * Required

All injuries must be reported to your supervisor immediately, who will then notify the Worker’s Compensation department to authorize medical treatment. In the case of emergency or after-hours accidents, seek immediate medical treatment and report the incident to our office on the next business day. A drug screen is required within 24 hours for all work-related injuries.

In accordance with state law, a positive drug test result will relieve the company and its insurers from responsibility for any medical expenses related to your injury. Refusal to submit to a drug test will have the same consequences as a positive test result. If an employee tests positive on a post-accident drug test, they will be terminated for violating the company’s substance abuse policy, and workers’ compensation benefits, as well as medical bills related to the injury, will be denied.

Employees are required to inform the doctor or medical facility that light-duty work is available and must follow the doctor’s instructions regarding light-duty assignments. Additionally, employees must forward all medical information related to the workplace injury within 24 hours of receipt and complete an injury/accident report within 24 hours of the incident.

I hereby authorize the company to conduct a thorough investigation into my references, work history, records, education, Social Security number, alien registration number, and any other matters related to my suitability for employment. I further authorize the references I have provided to disclose to the company any and all information, including letters, reports, and other details related to my work records, without providing prior notice of such disclosure. Additionally, I release the company, my former employers, and all other individuals, organizations, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising from or related to such investigations or disclosures. * Required

I understand that nothing in this application, the interview process, or any subsequent employment relationship is intended to create a contract of employment. If hired, I acknowledge that my employment will be at-will, meaning that either I or the company may terminate the employment relationship at any time, with or without cause or notice. I also understand that no statements or promises to the contrary are binding on the company unless made in writing and signed by both me and an authorized representative of the company. * Required

I hereby certify that I have not knowingly withheld any information that may negatively impact my eligibility for employment and that all information provided in this application is true and complete to the best of my knowledge. I further confirm that I have personally completed this application. I understand that any misrepresentation or omission of material facts—whether on this application or in any document used to obtain employment—may result in the rejection of my application or immediate termination of my employment, regardless of when such information is discovered. * Required

I understand and agree that any dispute, claim, or controversy arising out of or related to my employment or separation from employment with the company—including disputes with the company, its affiliates, successors, employees, or agents—shall be resolved through mandatory, binding arbitration. This arbitration will be conducted before a retired judge or a neutral arbitrator, mutually selected by both the company and me, in accordance with applicable arbitration rules. * Required

I certify that all statements and information I have provided during the application process are true and accurate to the best of my knowledge. I understand that any omission, falsehood, or misrepresentation—whether in this application or in any other documents submitted during the hiring process—may result in the rejection of my application or, if I am employed, the termination of my employment, regardless of when the company becomes aware of the issue. * Required

I understand that this application will be kept on file and considered active for a period not to exceed 90 days. If I wish to be considered for employment after that time, I understand that it is my responsibility to inquire about the availability of positions and, if applicable, submit a new application for consideration. * Required

By signing below, I certify that I have read, understood, and agree to all of the above statements, as indicated by my initials provided alongside each section.

Please upload your resume below. Note that submitting a resume does not replace the requirement to complete the full employment application. All applicants must complete the application in its entirety to be considered for employment.

Optional Disclosure (not a required disclosure to be considered for employment):

No applicant will be denied employment solely based on a criminal conviction. However, the nature of the offense, the date of the offense, the surrounding circumstances, and its relevance to the duties of the position applied for may be considered in making employment decisions. All information regarding criminal history will be kept confidential and used only as permitted by applicable law.

Have you ever been convicted of a criminal offense, including a felony or serious misdemeanor? Note: You are not required to disclose misdemeanor convictions for marijuana-related offenses that are more than two years old.

If yes, please state the nature of the crime, when and where the crime was convicted, and the disposition of the case.