Application For Employment

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

Current Address * Required

Best Phone Number to Reach You * 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:

Please give accurate and complete information. List your 3 most current employers staring 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.

(1) 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? * Required

Yes

No

Please include your job responsibilities below;

(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 is an At-Will employer. Employment At-Will may be terminated with or without cause, with or without notice at any time by the employee or the staffing company. No agreements contrary to this At-Will arrangement are valid unless they are in writing and signed by the President of the company. No supervisor or representative of the company has the authority to make implied or express agreements contrary to the foregoing. * Required

Employee/Employer Acknowledgement * Required

Advantage Business Services is a staffing referral company that refers candidates to Employers Outsourcing, Inc. as the employer of record. If hired, you will receive a weekly pay card or direct deposit from Employer's Outsourcing, Inc. based on your hours worked. All verifications of employment, requests for unemployment, disability or workers compensation benefits will be referred to Employer's Outsourcing, Inc. as your employer.

Payroll Deductions * Required

If hired, I authorize deductions when applicable to be made from my paycheck for errors and payroll, garnishments, and any overpayments made to me in error through payroll.

Substance Abuse Policy * Required

Any employee on duty or on company property who possesses, cells, receives, or is determined to measure all levels of any illegal drug or sufficient alcohol or marijuana to impaired performance in their blood or urine will be subject to immediate discharge, and inappropriate situations, referred to law-enforcement authorities. Entry onto the client worksite property is deemed to be consent to an inspection of a person, locker, vehicle , or any other personal effects. The company reserves the right to require employee testing for illegal or controlled drugs, alcohol, and marijuana, based on reasonable suspicion.

Reporting Discrimination & Harassment * Required

The company does not tolerate unlawful harassment or discrimination against any employee. If at any time you are subjected to or witness unlawful harassment or discrimination, including but not limited to harassment or discrimination based on race, sex, sexual orientation, pregnancy, age, religion, citizenship, color, veteran status, military status, unfavorable discharged from military service, prohibited retaliation, national origin, ancestry, mental or physical handicap, disability, or marital status, Employee will immediately contact Human Resources by phone at 805-754-3122.

Accident/Injury Procedure * Required

All injuries must be reported to your supervisor immediately, who will then report the incident to the Worker’s Compensation department for authorization of medical treatment. Emergency and after hours accidents should seek medical treatment immediately and report the accident to our office the following business day. A drug screen is required within 24 hours for all injuries. In accordance with state law, a positive test result, relieves the company and its ensures from any responsibility for any medical expenses, incurred and connection with your injury. Refusal to submit to a drug test will result in the same consequences as a positive drug test result. If an employed test positive on a post accident, drug test, they will be discharged for violation of the company, substance abuse policy, and workers, compensation, benefits, and or medical bills incurred by the employee will be denied. The employee is required to inform the doctor or medical facility. That light duty work is available. The employee will be required to work light duty per the doctors instructions. Employees are required to forward all medical information associated with the workplace injury illness within 24 hours of of receipt. Employees are required to complete an employee accident injury report within 24 hours of the injury.

I hear by authorize the company to thoroughly investigate my references, work, record, education, and Social Security number, alien, registration number, and other matters related to my suitability for employment and, further authorize the references I have listed to disclose to the company, any and all letters, reports and other information related to my work records without giving me prior notice of such disclosure. In addition, I hearby release the company, my former employers and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure. * Required

I understand that nothing contained in the application or confide during my interview, which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definitive or determinable period of time, and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and not no promise or representation, contrary to the foregoing or binding on the company and last maiden writing and signed by me and the company‘s designated representative * Required

I hear by certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certified that I, the undersigned applicant, have personally completed this application. Understand that any mission or statement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. * Required

I understand and agree that any dispute with any party, including the company, it’s affiliate, successor and other employees and employers that may arise from my employment or separation from employment with the company shall be resolved by mandatory, binding arbitration before a retired judge or other arbitrator selected by mutual agreement of the company and the employee. * Required

I certified that the statements and information furnished by me during this application process are true incorrect. I understand that omitted, false or misrepresented statements on this application or any other documents submitted as part of the application process our grounds for refusal to hire, or dismissal, regardless of when the company became aware of the omitted, falsified, or misrepresented information. * Required

While I understand that this application will be kept on file, I further understand that this application will be considered active for a period not to exceed 90 days. I understand that if I wish to be considered for employment beyond this, I should inquire as to whether applications are being accepted for the position for which i originally applied for, if so, submit a new application. * Required

My signature below certifies that I have read and that I agree with all the above statements for which I have included my initials .

Upload your Resume. Please note that even with a resume submission, the application for employment must still be completed.

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

No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances of the offense and the relevance of the offense to the position you are applying for may, however, be considered in employment decisions if relevant to the essential job functions which you would perform. Any information regarding criminal history will be maintained confidentially.

Have you ever been convicted of a criminal offense, felony, or serious misdemeanor? Misdemeanor convictions for marijuana related offenses more than two years old need not be listed.

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