Aarms Staffing Agency Inc:


Position applying for:  
EMPLOYEE INFORMATION
Name: 
 
Last
First
Middle
Telephone: Email: Alternate telephone:
Address:  
Social security number :
Birthday:
Are you able to perform the essential functions of If necessary for the job, I am able to: the position with or without accommodations?
   Yes         No
If necessary for the job are you older than:
    14     15     16    (Check one)
    18     19     21
I am legally eligible for employment in the U.S.?
   Yes         No
I am seeking a permanent position:  Yes     No
I will be able to report to work
  days after being notified I am hired
If necessary for the job, I am able to:
Work overtime?  Yes     No
Provide a valid NC Driver's License?  Yes     No
If so, fill out the following: Issuing state:
Type:  
Endorsement(s):  Hazardous Material     Passengers
               Tankers           Tank with Hazardous Materials
               School Bus     Double/Triple trailers
Work the following shifts: (check all that apply)
 Any    Day    Night    Swing    Rotating  
 Split    Graveyard    
EMPLOYMENT HISTORY
List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.
Employer name and address:

Pay: $  
Per: $  
Position title/duties, skills:
 
 
Start date:
End Date:
Reason for leaving:
Employer name and address:

Pay: $  
Per: $  
Position title/duties, skills:
 
 
Start date:
End Date:
Reason for leaving:
Employer name and address:

Pay: $  
Per: $  
Position title/duties, skills:
 
 
Start date:
End Date:
Reason for leaving:

Summarize other employment related to this job:
EDUCATION
 
Institution name
Years completed
Field of study
Graduate or degree
High school
College/university
Business/technical
Additional
MILITARY
Are you a veteran?           Yes   No
Duty/specialized training: 
SKILLS & QUALIFICATIONS
Other qualifications such as special skills, abilities or honors that should be considered:
Types of computers, software, and other equipment you are qualified to operate or repair:
Professional licenses, certifications or registrations:
Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employer’s attention:
Typing speed:       per minute
SKILLS & QUALIFICATIONS
List two personal references who are not relatives or former supervisors.
Name
Address
Telephone
Occupation
Years known
Name
Address
Telephone
Occupation
Years known
CONTACT
In case of accident or illness, please contact: Name: Daytime phone:
Address: Relationship:
INFORMATION TO THE APPLICANT
DISCLOSURE
In considering you for employment and, if you are employed, in considering you for subsequent promotion, assignment, reassignment, retention, or discipline, Aarms Staffing Agency (“the Company”) may request and rely upon one or more consumer reports or investigative consumer reports about you that we obtain from a consumer reporting agency, such as People Facts, Inc.
Aarms Staffing Agency Inc. is an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, handicap, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items.
CONSENT FOR BACKGROUND CHECK CONSUMER REPORTS (Criminal & Credit etc)
I have read and understand the foregoing Disclosure, and authorize the Company to obtain and rely upon consumer reports or investigative consumer reports in considering me for employment and, if I am employed, in considering me for subsequent promotion, assignment, reassignment, retention, or discipline. By my signature below, I authorize the Company to obtain any such reports and to share the information received with any person involved in the employment decision about me.
I authorize you to contact my current/previous employer for Employment and Reference Verifications. (This will authorize immediate inquiries to the Human Resources Department and to any listed supervisors or references in the Employment/Reference Section of your application.)
I also agree that this Disclosure and Authorization in original, faxed, photocopied, or electronic (including electronically signed) form will be valid for any consumer reports or investigative consumer reports that may be requested about me by or on behalf of the Company.
CONSENT FOR DRUG TESTING FOR PRE-EMPLOYMENT, RANDOM, OR REASONABLE SUSPICION AND RELEASE COVENANT NOT TO SUE AND INDEMNITY AGREEMENT
I hereby CONSENT to allow Aarms Staffing Agency thru People Facts or similar agency to take a specimen of my hair, urine, or blood and submit it for a pre-employment, random, or reasonable suspicion drug test screen.

I FURTHER CONSENT to allow the laboratory testing service to make the results of such screen available to Aarms Staffing Agency . In consideration for such services being rendered on my behalf, I hereby RELEASE the laboratory testing service, its officers, agents, and employees, from any and all claims which I might otherwise have due to such results being made so available.

I hereby CONSENT NOT TO FILE ANY ACTION at law or in equity against Aarms Staffing Agency , People Facts , the laboratory testing service, their respective officers, agents or employees in connection with the results of such screen being made so available, and I hereby agree to INDEMNIFY and HOLD HARMLESS Aarms Staffing , People Facts Inc, the laboratory testing service, their respective officers, agents, and employees from all damages, expenses, reasonable attorneys fees, and costs of court which they or any of them may suffer or incur, jointly or severally, due to the results of such screen being made so available.

I have the right to make a request to People Facts, Inc, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including sources of information, and the recipients of any reports on me which People Facts, Inc has previously furnished within the two year period preceding my request.

I certify that all of elements of the personal data I have provided are true, accurate and complete. I understand and agree that any omission, false statement, misleading statement, or answer made by me on my application or any supplements to it and in any interviews will be sufficient grounds for rejection of employment and my discharge after employment.
Signature of Applicant
Date