Workforce Capital Staffing Employment Application Form - Thomson, GA

  • Employment Application Form - Thomson, GA

    Please complete the form in its entirety.
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  • I understand that by accepting the position with Workforce Capital that I am committing to working the hours requested every day and that includes OT and Weekends.*
  • I understand that I am expected to perform the job duties in accordance with the production schedule and that I should be improving on a daily basis.*
  • I understand that my attendance, tardy and or leaving early or arriving late will affect my employment and can lead to termination.*
  • I understand that I am agreeing to a position that has a team of associates working and that I am expected to work in harmony with the team.*
  • I understand that the Safety and Quality of my work site is essential to my maintaining my position with Workforce Capital and violations will result in termination.*
  • Which shift is best for you to work?*
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  • Form: State G-4*
  • Form: Federal W-4*
  • Please choose your method of Weekly Pay*
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  • As a condition of employment, all individuals offered employment are required to pass a drug screen. Can you pass a drug screen?*
  • Have you ever been convicted of a crime before?*
  • Have you applied at Workforce Capital before?*
  • Have you worked for Workforce Capital before?*
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  • Education

  • Do you have a high school diploma or GED?*
  • Graduated?

  • Current Employment:

  • Are you currently employed?*
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  • May We Contact?*

  • Previous Employment:

  • Were you previously employed?*
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  • Medical History Form

  • Check the appropriate yes or no and complete the appropriate blanks.
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  • Do you have partial loss of hearing?*
  • Have you ever had an audio-gram hearing test?*
  • Do you need glasses to read or for distance?*
  • Do you have any serious wrist problems including Carpal Tunnel Syndrome?*
  • Have you had any broken bones?*
  • Do you have High Blood Pressure?*
  • Do you take medication to control High Blood Pressure?
  • Have you had any serious Injury/Injuries?*
  • Have you had a Hernia or Rupture?*
  • Have you had an Injured Back?*
  • Have you ever had Surgery?*
  • Have you ever refused surgery?*
  • Have you ever had an allergic reaction to any drugs?*
  • Have you ever had partial loss of uncorrected vision of more than 75% bilaterally?*
  • Have you ever had psycho-neurotic disability following confinement for treatment in a recognized medical or mental institution for a period in excess of six month?*
  • Have you ever had any permanent condition that constitutes 20% impairment of a foot, leg, hand, or arm, or of the body as a whole?*
  • Do you or have you within the past 90 days participated in recreational drug use?*
  • Have you ever participated in a drug abuse treatment program?*
  • Do you currently take any prescription medications?*
  • Do you have any condition or have you sustained any injury that would have an effect of your capacity to perform the duties of this position without reasonable accommodations?*

  • Estimate the number of workdays you have lost in each of the past two years.

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  • Have you ever been hurt on the job or filed a worker's compensation claim in the past?*

  • Applicant Acknowledgement

  • I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment which shall be active for 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time. I hereby understand and acknowledge that unless otherwise defined by applicable law, any employment relationship with this organization is an "at will" nature, which means that the Employee may resign at any time or the Employer may discharge the employee at any time with or without cause. In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. I understand that employment depends upon successful completion of required physical examinations and/or various tests including screening for illegal drug use. I also understand that it is my responsibility to inform this company upon completion of assignements within 24 hours and twice a week thereafter to inform of my availability. I understand also, that I am required to abide by all rules, policies and procedures of the employer and its clients.

     

     

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