EMPLOYMENT REQUEST

TeamOne Staffing Solution

333 State St, Perth Amboy, New Jersey 08861

TeamOne Staffing Solution is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below:

Personal Information

Name

Last Name

Address

City

State

Zip Code

Phone Number

Are you 18 or older?

Yes

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

Are you an American Citizen or are you an alien authorized to wok?

Yes

Date of Today

What document can you provide as proof of citizenship or legal status?

Employment Position

What days are you available for work?

What hours or shift are you available for work?

If needed, are you available to work overtime?

On what date can you start working if you are hired?

Do you have reliable transportation to and from work?

How did you get to know about the job offer?

Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Previous Employment

Employer Name

Job Title

Supervisor Name

Employer Address

City, State and Zip Code

Employer Telephone

Dates Employed

Reason for leaving

References

Please provide 2 personal and professional reference(s)

1. Reference Name

2. Reference Name

Reference Phone Number

AT-WILL EMPLOYMENT

The relationship between you and the TeamOne Staffing Solution is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the TeamOne Staffing Solution. No representative of TeamOne Staffing Solution has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.

Yo declaro que la informacion que acabo de proveer es correcta y completa

Thanks for submitting

EMPLOYMENT REQUEST

Employer Name

References Please provide 2 personal and professional reference(s)

References

Please provide 2 personal and professional reference(s)