Independent Contractor Agreement
The persons who are added to CSS' Jobs Interface must agree to CSS's Workers' Policy and Contracts. Applicants who are selected as Temporary '(Independent) Contractors' and 'Employees' must be able to verify qualifications, background and eligibility to work in the territory of employment. All information obtained in this form and over our interview process, will be held in strict confidence, subject to your consent and to applicable law. CSS will not discriminate because of sex, age, race, physical disability, religion, ethnicity, marital status, ancestry, or place of origin. Applicants MUST be legally eligible to work in the territory of employment, and MUST give full consent to previous employers for the release of employment information. Selected 'independent contractors' working in the US MUST complete a W-9 Form before being assigned to an employer, and MUST possess personal liability coverage. All applicants understand that they AGREE to the terms of this agreement by signing and submitting this application Form, and attaching a valid national ID confirming signature and appearance.
Enter Your E-mail Address:
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example@example.com
Full Name
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First Name
Middle Name
Last Name
Date of Birth
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Month
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Day
Year
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What is your Social Security number?
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Day Time Phone
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Area Code
Phone Number
What is your desired salary?
What position are you applying for?
Are you a US Citizen?
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Yes
No
If you answered 'No' above, are you authorized to work in the U.S.
Yes
No
Have you ever worked for this company?
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Yes
No
If you answered 'Yes' above, please tell us when:
Have you ever been convicted of a felony?
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Yes
No
If you answered "Yes" above, then please explain here:
ACADEMIC HISTORY
- HIGH SCHOOL ATTENDANCE
What High School did you attend (if any)?
When did you start?
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Month
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Day
Year
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When did you leave?
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Month
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Day
Year
Date Picker Icon
Did you graduate?
Yes
No
What certification did you receive (if any)?
ACADEMIC HISTORY
- COLLEGE ATTENDANCE
What College did you attend (if any)?
When did you start?
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Month
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Day
Year
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When did you leave?
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Month
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Day
Year
Date Picker Icon
Did you graduate?
Yes
No
What certification did you receive (if any)?
ACADEMIC HISTORY
- TRADE SCHOOL OR CERTIFICATION
What Trade/ Certification school did you attend (if any)?
When did you start?
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Month
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Day
Year
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When did you leave?
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Month
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Day
Year
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Did you graduate?
Yes
No
What certification did you receive (if any)?
REFERENCES
CSS will NOT consider OR interview anyone who cannot provide references on request. These must either be: a State or Federal Official, a previous Employer, an Educator who taught you, a Religious Leader of your congregation, or a CSS Manager. Please list three personal references::
Name (Reference 1)
First Name
Last Name
Relationship
Phone Number
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Area Code
Phone Number
Name (Reference 2)
First Name
Last Name
Relationship
Phone Number
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Area Code
Phone Number
Name (Reference 3)
First Name
Last Name
Relationship
Phone Number
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Area Code
Phone Number
WORK HISTORY
Please list your last three employers
Company Name
When did you start?
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Month
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Day
Year
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When did you leave?
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Month
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Day
Year
Date Picker Icon
What was your reason for leaving?
Company Name
When did you start?
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Month
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Day
Year
Date Picker Icon
When did you leave?
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Month
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Day
Year
Date Picker Icon
What was your reason for leaving?
Company Name
When did you start?
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Month
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Day
Year
Date Picker Icon
When did you leave?
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Month
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Day
Year
Date Picker Icon
What was your reason for leaving?
SUPPORTING DOCUMENTS
Click Here to Upload any Supporting Documents (eg. a Resume or Letter)
Click Here to Upload Your Government Issued ID (Mandatory)
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Please Read Carefully Before Signing This Form
By signing and submitting this form I hereby state that all information provided is accurate and may be verified by CSS. I agree that I may be discharged if CSS at anytime learns of falsification or material omission in the information provided on this application form and related documents. CSS may contact my former employers, and all references are hereby authorized to release all information which they may deem relevant to my employment. I hereby release CSS, its affiliates, successors, representatives, and all references from any liability that might be claimed because of information provided by such references. I agree that I will follow CSS's policies, rules, and procedures. I understand that transportation to and from assigned work premises is solely my responsibility, and that CSS can face no liability for accidents, mishaps or any other loss resulting from my commute. I understand that if I am contracted as a Temporary Contractor for my skills, I am required to submit a completed W9 Form and am responsible for my Liability Insurance, Federal Taxes, State Taxes and other relevant deductions. I understand that CSS reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime.
Type Signature as Name appears on ID
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