Online Application

Employment Application
Please answer all appropriate questions completely and accurately. False or misleading statements during an interview or on this form are grounds for terminating the application process or, if discovered after employment, terminating employment.

Please do not submit more than one application every 90 days.
What categories would you prefer? *
For which schedules are you available? *

APPLICANT INFORMATION

CURRENT PHYSICAL ADDRESS *
CURRENT PHYSICAL ADDRESS
City
State/Province
Zip/Postal
MAILING ADDRESS
MAILING ADDRESS
City
State/Province
Zip/Postal
PRIOR ADDRESS *
PRIOR ADDRESS
City
State/Province
Zip/Postal
10 digit cell number - Area Code and phone no "1" before area code
ARE YOU A US CITIZEN? *
ARE YOU AUTHORIZED TO WORK IN THE US? *
ARE YOU OVER THE AGE OF 18? *
Have you ever worked for StaffRite or been placed for employment by StaffRite? *
Have you ever been convicted of a felony? *
If yes, please provide the following information: (You are not obligated to disclose any reference to a pre or post trial diversion program. any conviction which has been sealed, expunged or erased by the court.)
DO YOU HAVE A VALID DRIVER'S LICENSE? *
Have you had any moving violations within the last seven years? *

EDUCATION

Most recent employer: Are you currently working for this employer? *
May we contact this employer? *

Current or most recent employer

Month / Year
Month / Year - If still employed enter todays date

Second most recent employer:

Month / Year

Third most recent employer:

Month / year
Month / Year

REFERENCES

Would you like to be added to our email list for new positions that fit your experience? *

In order to best provide you and our employers the most relevant opportunities, please select all job experience you have had in the last 10 years.

Accounting Experience

Office/Clerical

Industrial

Manufacturing

Technical

Hospitality

Medical

General Labor

IF YOU HAVE A RESUME PLEASE UPLOAD IT HERE
Maximum upload size: 30MB
I certify that I have read and understand this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this document or not, may result in rejection of my application or discharge at any time during my employment. I authorized the company and/or its agents, including consumer reporting bureaus, to verify any of this information. I release all former employers, persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.