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Machine Operator

25 Oct
By admin

Staff Source Online Application

First Name * : – Last Name * :

Address1* :

Address2 :

City *: – State * : – Zip * :

Home Phone : ()()-()

Cell Phone : ()()-()

Your Email :

Do you have your own vehicle? –  Yes No

Emergency Contact :

Emergency Phone : ()()-()

Referral Source :

Available Date (M/D/Y) *: / /

Position applied for :

Day(s) Available :  Sun Mon Tue Wed Thur Fri Sat

Desired Salary ($) : – Minimum Rate: ($) :

Desired Location : ––

Highest level of school completed * : Date completed :

School Name :

Skill(1) : Skill(2) :

Skill(3) : Skill(4) :

Last Employer

Company : 
Title   : 
Job Description : 
City :  - State : 
Phone : ()()-()
From :  /  /   - To :  /  / 
Reason for Leaving : 
Salary ($) :  -

Past Employer

Company : 
Title   : 
Job Description : 
City :  - State : 
Phone : ()()-()
From :  /  /   - To :  /  / 
Reason for Leaving : 
Salary ($) :  -

Staff Source is an equal employment opportunity employer and is in full compliance with any and all applicable anti-discrimination laws, rules, and regulations. Staff Source agrees not to harass, discriminate against, or retaliate against any employee of the other because of his or her race, national origin, age, sex, religion, disability, marital status, or other category protected by law; nor shall either party cause or request the other party to engage in such discrimination, harassment, or retaliation. In the event of any complaint of unlawful discrimination, harassment, or retaliation by any Employee, Staff Source agrees to cooperate in the prompt investigation and resolution of such complaint.

I understand that I am applying for temporary work and will be paid only for the number of hours actually worked. I understand that if my assignment should lead to a full-time permanent position, my employer will be obligated to pay an additional fee to Staff Source, which is to be determined at the time of hiring. If my prospective employer refuses to pay the necessary fee, I agree not to accept a permanent position with the employer. If I do not accept employment or if I accept employment with another temporary service at any company referred to me by Staff Source, I agree to personally guarantee to Staff Source payment of the amount due for its fees and all costs and expenses including attorney’s fee arising out of my employer’s refusal to pay the necessary fee.

I understand that Staff Source works with several companies that have very strict “NO DRUG POLICIES”. In order to qualify as an applicant to work at these companies, I understand that I must successfully pass a drug test. I further understand that Staff Source can give me a random drug test at any time. I realize that if I fail the drug test, I will immediately be terminated and be required to reimburse Staff Source for the cost of the test.

Accept Terms and Conditions :

Entering your Social Security Number is a confirmation that you read and accepted the above terms of employment.

Social Security * – ––

Have you ever been Convicted of a Felony? * Yes No

Are you 18 years or older *:  Yes No

Upload Resume (Filetype: doc/pdf – Max: 2MB) * :

Answer (*): 2 + 7 = ?   – Sending ...

(*) = Required Field