Personal Information

    Are you a U.S. citizen?
    Are you authorized to work in the U.S.?
    Have you ever been convicted of a felony?

    Objective

     

    Locations

     

    References

    Add your professional references. Do not include friends or relatives.
    + Add Reference
    Can you lift 50 lb continuously?
    Puede levantar 50 lb continuamente?
    Are you available to work
    Esta disponible para trabajar:
    Can you travel if a job requires it? Puede viajar si un trabajo lo requiere?

    Authorization

    I hereby certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that falsification of this information may prevent me from being hired or lead to my dismissal if hired.

    I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

    Terms and Conditions
    Employer of Record. I acknowledge that my employer of record for my initial job assignment and any subsequent assignments is RMR STAFFING CORP. As such the applicable terms and conditions of this original job application should apply to my initial assignment as well as any subsequent assignments unless changed and/ or modified by RMR STAFFING CORP. in writing. In the event that any of the terms and conditions of this job application is deemed to be unenforceable such determination will not void the validity of any other provision and this shall be adjusted so as to reflect the intent of said provisions to the greatest extent possible.
    Termination of Employment. As an employee of RMR STAFFING CORP, I agree to comply with all RMR STAFFING CORP regulations and understand that my employment with RMR STAFFING CORP may be terminated at any time by me or RMR STAFFING CORP. with or without notice for any reason. I also understand that job abandonment with or without notice is subject to immediate termination I also understand that in order to be considered for temporary job assignments I MUST register my availability for work with RMR STAFFING CORP. on a daily
    basis and that failing to do so may affect my eligibility for unemployment compensation. Likewise, I understand that registering my availability for work does not constitute employment; that I am not employed until I actually begin working on a job assignment, and that my employment with RMR STAFFING CORP. is TERMINATED at the end of each day.
    Safety. As an employee of RMR STAFFING CORP. I am aware I must wear and/or use ALL safety equipment provided to me by either
    RMR STAFFING CORP its customers or self-owned, for the performance of any job assignment. I understand that failure to do so can result in the immediate termination of my employment with RMR STAFFING CORP or the temporary suspension from any current job assignments at the sole discretion of RMR STAFFING CORP. I am aware I am required to contact my immediate supervisor and RMR STAFFING CORP.
    If I believe the job assignment is unsafe. I also understand that in the event I suffer a WORK-RELATED injury or illness while at a job assignment
    I MUST immediately report the injury or illness to my direct supervisor and RMR STAFFING CORP. in order to receive medical attention. Furthermore, I understand that unless emergency treatment is required as a result of a work-related injury or illness, in which case 911 should be contacted immediately, all work-related injuries will be treated at the designated Medical Network Provider facilities of:
    I agree to not hold RMR STAFFING CORP, it's officers and employees harmless for any penalties, fines, and work related injuries during my employment with RMR STAFFING CORP Furthermore, I understand that except where limited or prohibited by law, in the event I suffer a job related injury or illness I will be tested for the presence of drugs and/or alcohol in accordance with acceptable medical procedures.

    I am aware that, subject to applicable law, refusing to submit to testing may subject me to dismissal. I therefore agree to hold harmless RMR STAFFING CORP its principals, agents, employees and clients for any and all consequences arising from my testing positive for the use and/or influence of drugs and/or alcohol at the time of my injury or illness.

    Therefore, I agree that in the event I am injured or become ill while working for RMR STAFFING CORP. I will look only to RMR STAFFING CORP Workers Compensation coverage and not to its customer for any recovery. For myself and on behalf of my heirs, executor, personal representatives and assigns, I waive, release and forever discharge any claim that I may now have or that may later accrue against any customer of RMR STAFFING CORP. which directly or indirectly results from any injuries which may occur to me while on a temporary work assignment for RMR STAFFING CORP. I further elect and agree that the only remedy for any injury or illness sustained while working for RMR STAFFING CORP. and its customer is exclusively the Workers' Compensation coverage provided by RMR STAFFING CORP. I understand I am not waiving or releasing any claims which I may have against the Workers' Compensation coverage provided by RMR STAFFING CORP.
    Drug Testing. As an employee of RMR STAFFING CORP. I agree to be drug tested when required by a job assignment if I wish to be considered for said assignments. I agree that by consenting to be drug tested I am also consenting for the result of such test to be shared with RMR STAFFING CORP. customers. I understand that a positive drug test can, at the sole discretion of RMR STAFFING CORP result in the immediate termination of my employment with RMR STAFFING CORP.
    Workplace Conduct. As an employee of RMR STAFFING CORP. I understand that I am always expected to conduct myself in a professional manner while on a job assignment. I am aware common courtesy and respectful behavior towards co-workers and management staff is the norm. Furthermore, I understand the use of profanity, abusive and derogatory language, theft and/or fraud, property damage, harassment, fighting, tardiness and poor performance will, upon the sole discretion of Delta Group Enterprise Inc. result in my temporal suspension or the termination of my employment.
    Fringe Benefits. I understand that my employment with RMR STAFFING CORP. does not include fringe benefits of any type.

    Dispute Resolution. RMR STAFFING CORP. and I agree that in the event of any claims resulting from or in relation with this Employment
    Agreement, including but not limited to its breach, my application, termination of employment, alleged violations of constitutional rights, federal, state
    or local laws will be resolved by binding arbitration under the Federal Arbitration Act and be administered by the American Arbitration Association under the Employment Arbitration Rules in effect at the time of the arbitration. If Arbitration is not enforceable,
    RMR STAFFING CORP. and I, agree to present our claims for resolution by a bench trial (trial by judge.)

    Representative Actions or Actions on Behalf of Others. I agree that in order to be represented by others in a lawsuit against RMR STAFFING CORP. my written consent must be first obtained by the representing party. Likewise, I agree not to represent anyone else without first securing their writing permission.

    RMR STAFFING CORP and I agree that in the event of any claims resulting from or in relation with this Employment Agreement, including but not limited to its breach, my application, termination of employment, alleged violations of constitutional rights, federal, state or local laws, shall be processed with proper authorities within thirty (30) days from the date of the incident.

    Commuting. As an employee of RMR STAFFING CORP I agree that is my sole responsibility to secure the proper means of transportation, be either public or private, to the job location of my assignment.

    Release of employment records authorization. I agree that by completing this job application I am authorizing RMR STAFFING CORP to keep certain records related to my employment including but not limited to this application, 1-9 forms and any drug test results, and to release, upon request, these records to third parties such as RMR STAFFING CORP customers. By completing this application, I am also authorizing RMR STAFFING CORP to contact my present and past employers for the purpose of confirming my past employment history including but not limited to,
    length of employment, wages and performance.
    agree to release and indemnify RMR STAFFING CORP, it is officers and employees harmless for any penalties, fines, and work-related injuries during my employment with Delta Group Enterprises

    Digital Signature