SLSS New Employment Application Questions 9-2019

Employment Application Form

General Information

SSN

First name

Middle name

Last name

Address

Address 2

Main phone

City

State

Zip

Marital status

Employee dob

Employee gender

Employee date of hire

Branch

Let’s take time to get to know you.

Please take a few minutes to answer the questions below to make sure our working environment meets your expectations and to assure we are a right fit for your employment needs.

Please note: This application form was designed for use by persons applying for various types of positions. Please answer the questions to the best of your ability.

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on the basis of race, color, creed, religion, national origin, age, sex, sexual orientation, gender, gender expression or identity, marital status, veteran status, pregnancy, physical or mental disability, genetic characteristics or any other basis protected by federal, state or local law, ordinance or regulation. The Company will reasonably accommodate qualified individuals with known disabilities unless the accommodations would impose undue hardship on the Company’s operation.

Do you have the legal right to work in the U.S.?

Can you read and write english?

If hired, are you willing to submit to and pass a controlled substance test?

Do you have reliable transportation?

Are you able to work in a cold environment?

Are you able to stand for long periods of time?

Are you able to lift up to 50 lbs?

Are you able to work in loud and/or noisy environment?

Are you able to work in an environment containing spices and various food products?

Have you operated any equipment?

Are you able to work in a fast-paced environment?

If hired, will you be able to work overtime?

Are you at least 18 years of age?

If under 18, do you have a work permit?

Position applying for

Have you ever been employed by Simplified Labor Staffing Solutions, Inc.? lf so, when and where?

Have you worked for a temporary agency in the last (2) years?

How were you referred to us?

Name of referral source:

Education Information

Schools attended or graduated from:

High School College or University

School name(s) and address:

Degree earned:

High School GED Under Graduate Graduate

If College or University (Major Studies):

Vocation:

For Clerical Applicants Only:

Do you type?

Computer skills (hardware/software)

Employment History

List all employers, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.

Most recent employer

Is this your current employer?

Can we contact this employer for references?

Employer name

Employed from

Employed to

Job title

Employer address

Supervisor’s name

Supervisor’s phone

Job duties and responsibilities

Reason for leaving

Next Most Recent Employer

Employer name

Employed from

Employed to

Job title

Employer address

Supervisor’s name

Supervisor’s phone

Job duties and responsibilities

Reason for leaving

Next Most Recent Employer

Employer name

Employed from

Employed to

Job title

Employer address

Supervisor’s name

Supervisor’s phone

Job duties and responsibilities

Reason for leaving

Next Most Recent Employer

Employer name

Employed from

Employed to

Job title

Employer address

Supervisor’s name

Supervisor’s phone

Job duties and responsibilities

Reason for leaving

Other Information

Volunteer activities (list organization, type of service, dates)

Hobbies, interests (optional)

INDUSTRY

INDUSTRYPlease check the appropriate boxes for the industries you have experience with
DISTRIBUTION CTR FOOD PROCESS. FULFIL. CENTER 3RD PARTY LOG. MANUFACTURING WAREHOUSING USDA PLANT FDA PLANT

CHECK ONLY SKILLS WHERE YOU HAVE WORK EXPERIENCE

Certification and Authorization

The above information is true and correct. I understand and agree that Simplified Labor Staffing Solutions, Inc. may verify the information provided and that any falsification of information will constitute grounds for immediate dismissal, whenever discovered.

I authorize the Company to inquire into my education, past employment history, and references as needed to research my qualifications for this position.

I understand that Simplified Labor Staffing Solutions, Inc. is committed to maintaining a safe, efficient, and drug free environment, and that any offer of employment is contingent upon the results of a drug screen. Further, I understand that any offer made to me, verbal or written, will be rescinded and voided if I refuse to comply with the drug screen process.

I understand that although the Company is not asking about criminal convictions on this Application, that should I receive an offer of employment, the Company may conduct a criminal background check and may also inquire whether i have been convicted of a criminal offence, felony or misdemeanour (exclusive of any juvenile convictions, marijuana related conviction over two years old; any conviction for which the record has been judicially ordered sealed, expunged, or statutorily eradicated; any misdemeanour conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed; or any arrest for which a pretrial diversion program has been successfully completed.). I understand that if i am denied employment based upon my criminal history, the Company will provide me with a written assessment of how my criminal history disqualifies me from performing the job, and will offer me the opportunity to provide mitigating information.

If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for the completion of Form I-9.

If employed, and in consideration of my employment, I agree to confirm to the rules, procedures and policies of Simplified Labor Staffing Solutions, Inc. I understand that if i am hired, my employment will be at-will.

I hereby acknowledge that i have read and agree to the above statements.

Signature

Date

Simplified Labor Staffing Solutions, Inc. requires that all disputes regarding employment with Simplified Labor Staffing Solutions, Inc. and regarding the application for employment with Simplified Labor Staffing Solutions, Inc. be resolved through binding arbitration. If employed, and in consideration of my employment, I agree to be bound by Simplified Labor Staffing Solution, Inc.’s arbitration policy.

I acknowledge that i have read and agree to the above terms and conditions.

I acknowledge that i have read and agree to the above terms and conditions.

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Corporate Office

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Brea

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3 Pointe Dr. #210 Brea, CA 92821

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714-441-8072

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CONTACT@YOURSTAFFINGFIRM.COM

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New Jersey

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519 Elizabeth ave, Elizabeth, NJ, 07206

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908-576-8181

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Commerce

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2122 S. Atlantic Blvd Commerce, CA 90040

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323-284-6779

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Lynwood

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10919 Atlantic Ave Lynwood, CA 90262

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323-284-6778

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Sumner, Washington

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615 E Pioneer, Suite 207 Puyallup, WA 98372

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253-561-3115

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Whittier

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14714 Whittier Blvd Whittier, CA 90603

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562-478-4901

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Ontario

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1035 S. Millken Ave Suite A Ontario, CA 91761

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909-294-7822

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Carson

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860 E. Carson St #114 Carson, CA 90745

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310-362-0647