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EMPLOYMENT FORM

    Present Status of License

    Are legally eligible to work in the United States of America?

    Are you able to meet the attendance requirements?

    Do you have any objection to working overtime if necessary?

    Can you travel if required?

    Have you ever been previously employed by this company?

    Have you been convicted of a crime in the last 7 years?

    SELECT A JOB CATEGORY

    (required)

    Construction

    Hospitality

    EXPERIENCE

    Please provide all employment information for your past three employers starting with the most recent.

    Employer 1

    Dates of Employment

    Employer 2

    Dates of Employment

    Employer 3

    Dates of Employment

    REFERENCES

    Give below the names of three persons not related to you, whom you have known at least one year.

    EDUCATION

    Are you a veteran of the U.S. Military service?

    CERTIFICATE OF APPLICATION (Read Carefully Before Signing.)

    All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or if employed, may result in subsequent dismissal. I hereby authorize all former employers, educational institutions, personal references and others identified hereon, including their employees and representatives, to furnish or provide full and complete reports, documents or information to Optimus Staffing or its representatives concerning my prior educational and work histories, criminal and driving records, or other information I have provided hereon. I waive, release, indemnify and hold harmless Optimus Staffing, employees and representatives and all other persons or entities from all liability and all claims of any nature whatsoever pertaining to the disclosure or use of information or written material as described above. I understand this is a preliminary application and not a contract to employ me.

    Furthermore, in the event I am employed, my employment shall be completely voluntary and may be terminated at will at any time by either myself or the company. If employed, I agree to comply with all rules of the company as a condition of continued employment.

    RELEASE & WAIVER FORM FOR PRE-EMPLOYMENT BACKGROUND INVESTIGATION (Read Carefully Before Signing.)

    I authorize Optimus Staffing. to seek and obtain consumer reports/investigative reports about me as defined in the Fair Credit Reporting Act(FCRA). These investigative reports may include, but are not limited to federal, state, and county criminal search, nationwide criminal index search, sex offender search, employment verification, education verification, social security number trace, credit check, terrorist watch lists, DMV search, performance questions (to include drug and alcohol testing programs), and drug screening. I understand that these records may be used for the eligibility and qualification of my employment. I hereby authorize, without any reservation, the full release of these records and information for Optimus Staffing. and/or its agents to conduct the searches.

    I also authorize the full release of the information described above, without any reservation, throughout any duration of my employment at Optimus Staffing. I also certify that all information provided in this application for employment is correct to the best of my knowledge. I agree that a copy or facsimile of this authorization shall be as valid as the original. In addition, I release and discharge Optimus Staffing, and all of its agents, any expenses, losses, damages, and liabilities for the investigative process. Upon request, Optimus Staffing. will supply a copy of my reports and my rights under the Fair Credit Reporting Act. Requests may be directed to: Optimus Staffing. or by contacting us at 407 334 3296

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