EMPLOYMENT APPLICATION
This Agency is an equal opportunity employer and fully subscribes to the principles of Equal Employment Opportunity. It is the policy of this Facility to provide employment based on qualifications, without regard to race, color, religion, national origin, age, sex, veteran status or disability, or any other basis prohibited by federal or state law. As an equal-opportunity employer, this Agency intends to comply fully with all federal and state laws. The information requested on this application will not be used for any purpose prohibited by law.
Personal Information
Employment Eligibility
Specify the start and end dates you worked for HSE Staffing Agency
Employment Desired
Education
Schools Attended
Licensure / Certification
Work History
Former Employment
References
List two professional references (Non-Relatives) we may contact
EMPLOYMENT UNDERSTANDING
Please read the following statements carefully before you consent to each paragraph and sign your name. “I HEREBY CERTIFY that the answers given by me to the above questions and statements are true and correct and hereby voluntarily authorize this Agency (HSE Staffing Agency) to contact references, past or present employers, schools, law enforcement agencies, and any other sources of information which may be relevant to my application for employment. Further, I release from all liability or responsibility all persons, companies, or corporations supplying such information. I voluntarily grant this release to support my application for employment at HSE Staffing Agency LLC and agree to inform the Agency of any special concerns I may have related to information which may be discovered during this investigation in the space below. I further understand that all information and documents acquired by HSE Staffing Agency LLC will be maintained as confidential by the Agency and that the Agency will not release such information to me. It is understood and agreed that any misrepresentation, false statement, or omissions by me in this Application will be sufficient reason for rejection of my application or for dismissal at any time during my employment, without liability to this Agency. I have read, understand and agree to the above statement.
This means there are no guaranteed hours as this is a temporary staffing agency. Employee is provided with the facility's needs and can choose what days they can and cannot work. Work will be offered to employee when work is available and employee chooses to schedule self.
Employee is aware that facility will request certain employees and continue using them as needed as long as they meet the facility needs.
Employee understands that if call off occurs twice in a one-month period, this can be grounds for termination per employment contract. It also may cause lack of work as the facility may temporarily offer scheduled work to other employees who have perfect attendance and provide work that meets the facility standards.
Employee is aware this is a temporary agency that only offers temporary work as needed by the facilities. With the written consent of HSE Staffing Agency, employee is free to apply for other agencies or any other type of employment as this is temporary employment.
Employee can choose to work on a full time, part time or PRN basis of up to 36 hours per week if work permits.
This agency doesn’t guarantee work per employment contract between the employee and HSE Staffing Agency LLC.
CONFIDENTIAL INFORMATION
As used herein “Confidential Information” shall mean any and all technical and non-technical information provided by the HSE Staffing, including but not limited to: data or other proprietary information relating to products, inventions, plans, methods, processes, know-how, developmental or experimental work, clients names, list of clients and their contact, employees including names, address, phone numbers or any other contact methods, customer lists (including the names, or practices of any clients), the names of vendors or suppliers, marketing methods, reports, analyses, business plans, financial information, statistical information, or any other subject matter pertaining to any business of the Company or any it’s respective clients, consultants, or licensees that is disclosed to the recipient under the terms of this Agreement.
Employee may have had access to proprietary, private and/or otherwise confidential information ("Confidential Information") of HSE Staffing. Confidential Information shall mean all non-public information which constitutes, relates, or refers to the operation of the business of the Company, including without limitation, all financial, investment, operational, personnel, sales, marketing, managerial and statistical information of the Company, and any and all trade secrets, customer lists, or pricing information of the Company. Employee will not at any time or in any manner, either directly or indirectly, use for the personal benefit of the Contractor, or divulge, disclose, or communicate in any manner any Confidential Information. Contractor will protect such information and treat the Confidential Information as strictly confidential.
This provision shall continue to be effective after the termination of this Agreement. Upon termination of this Agreement, Employee will return to HSE Staffing all Confidential Information, whether physical or electronic, and other items that were used, created, or controlled by the Contractor during the term of this Agreement.
Non-Compete
During this agreement Employee shall not represent, provide services for, or engage in any other way any other business of a similar nature to the business of HSE Staffing without the written consent of HSE Staffing, if employee own or operate a similar business as HSE Staffing, Employee can’t use any information provided by HSE to contact HSE Staffing clients or conduct business with them for one year after the termination of employment between HSE Staffing and employee.
INDEMNIFICATION
Employee agrees to indemnify and hold harmless Company from all claims, losses, expenses, fees including attorney fees, costs, and judgments that may be asserted against the Company that result from the acts or omissions of the employee, the employee’s agents.
By signing below I agree to all of the above terms and conditions of employment.
By signing your name electronically on this employment application, you are agreeing that your
electronic signature is the legal equivalent of your manual signature on this Form.