Using this application does not guarantee a job offer, employment, or being contacted for an interview. Its primary purpose is to increase your chances of being considered for future job openings, based on your profile, experience, and alignment with the company’s needs.

Submitting your information does not constitute any obligation or commitment from the DreamJob Staffing. All hiring decisions will be made based on internal criteria, position availability, and candidate suitability.

If you agree with these terms, please complete the required information and proceed. We appreciate your interest. Thank you!

ATTENTION APPLICANT 

You must complete the online application in one session.
After submitting, please visit the nearest DreamJob Staffing location to complete your interview.

Are you able to provide information that establishes your identity and eligibility to work in the country?

I understand that, to receive payment timely, I must clock in and out promptly for each day I work. Days that I fail to clock in and out will not be paid until the next paycheck (the following week I understand that, to receive payment timely, I must clock in and out promptly for each day I work. Days that I fail to clock in and out will not be paid until the next paycheck (the following week

State Government Policy prohibits discrimination based on race, sex, color, creed, national origin, age, or disability. The information requested in no way affects you as an applicant. This form will be retained in Human Resources. Its sole use is to ensure our recruitment efforts reach all segments of the population.

 

Disability: A disability is any impairment, which substantially limits one or more life activities. A disabled person is one who (i) actually has such an impairment; (ii) has a record of such an impairment, or (iii) is regarded as having such an impairment. You may identify yourself as a person with a disability at any time during your employment. Disclosure is voluntary.

• Report your injury to your supervisor immediately.
• Horseplay is always prohibited.
• Report any unsafe conditions immediately to your employer/supervisor.
• Alcoholic beverages are not permitted on the job during work hours. Any employee proven to be under the influence of drugs or alcohol on the job will be terminated.
• If you do not have first aid training, do not move or treat an treat an injured person unless there is an immediate peril such as profuse bleeding or stoppage of breathing.
• Where there exists the hazard of falling objects an approved hard hat must be worn.
• You should not perform any task unless you are trained to do so and are aware of the hazards associated with the task. You may be assigned certain personal protective safety equipment. This equipment should be available for use on the job, be maintained in good condition, and must be worn as required.
• Learn safe work practices. When in doubt about performing a task safely, contact your supervisor for instruction and training.
• The riding of a hoist hook or on other equipment not designed for such purposes is always prohibited.
• Never remove or by-pass safety devices.
• Do not approach operating machinery from the blind side; let the operator see you.
• Learn where fire extinguishers and first aid kits are located.
• Always maintain a general condition of good housekeeping on all work areas.
• Obey all safety regulations when operating Forklifts and all other riding equipment.
• Be alert to hazards that could affect you fellow employees.
• Obey safety signs and tags.
• Always perform your task in a safe and proper manner, do not take shortcuts. The taking of shortcuts and the ignoring of established safety rules is a leading cause of employee injury.
• As an internal policy, the workday will not be paid if the work hours are not completed in full.
• To resign from your job you must give at least 72 hours notice.
• If you leave your job, without prior notice or notification, your pay will be withheld for up to 15 days, in order to make sure that everything in the company is fine and you are not leaving because of some altercation that we do not know about.

I certify that I have read, understand, and will abide by all the above safety. Failure to do so may be grounds for termination and may disqualify my Unemployment Insurance Benefits.

In connection with my application for employment, I understand that a consumer report may be requested that will include information as to my character, work habits, performance and experience, along with reasons for termination of past employment. I understand that as directed by company policy and consistent with the job described, you may be requesting information from public and private sources about my: driving record, criminal record, education, credentials, credit and references. I voluntarily and knowingly authorize the company and/or its agents to verify any aspect of the information contained in my employment application through public and private sources. I further understand that mis representations or omissions in my employment application may be cause for rejection or may be cause for subsequent dismissal if I am hired.

If an accident occurs while on assignment at DreamJob LLC, I hereby authorize DreamJob LLC to request and obtain records regarding my accidents or occupational disease. This includes doctors’ reports, follow-up reports, nurses’ notes, medical bills, test results, insurance records, etc. A facsimile or copy of this authorization shall be considered as affective and valid as the original.

According to the Fair Credit Reporting Act (FCRA); I am entitled to know if employment is denied because of information obtained by my prospective employer from a consumer-reporting agency. If so, I will be notified and given the name and address of the agency or the source which provided the information.

I voluntarily and knowingly fully, release and discharge, absolve, indemnify and hold harmless you, you agents and any former employer, person, firm, corporation, school or government agency, its officers, employees and agents from any and call claims, liability, demands, causes of action, damages, or costs including attorney’s fees, present or future, whether known or unknown, anticipated or unanticipated, arising from or incident the disclosure or release of an such information to you, your agents, or consumer reporting agency. I hereby authorize you to procure report as part of the pre-employment background investigation. If hired, the authorization will remain on file and shall service as an ongoing authorization for you to procure consumer reports at any time during my employment.

 

Please fill out this form only if you are waiving (not applying) for coverage in DREAMJOB STAFFING Health Plan. You should return the form to Dream Job LLC.

We will keep this waiver of coverage as evidence that you did not want to enroll in DREAMJOB LLC for the plan year.

If you have any questions, or if you think you may be eligible to enroll in DREAMJOB LLC group health plan prior to the next open enrollment period, please contact us 888-713 7326.

I understand that if I am declining enrollment for myself or my dependents because of other health care coverage, I may enroll myself or my dependents in DREAMJOB LLC group health prior to the next open enrollment period in limited circumstances. To do this, I must have involuntarily lost my other coverage and I must submit a completed enrollment application within 30 days after my other coverage ended.

I also understand that if I have new dependents as a result of marriage, birth, adoption, or placement for adoption, I may be able to enroll myself and my dependents, provided I submit a completed enrollment application within 30 days after the marriage, birth, adoption, or placement for adoption.

I acknowledge that I have been offered the opportunity to enroll in DREAMJOB LLC group health plan for myself and my dependents, and that I have reviewed the open enrollment materials provided to me by DREAMJOB LLC. I am declining to enroll in DREAMJOB LLC group health plan at this time.

 

Benefits Waiver for assigned Employees / Assigned Employee Confidentiality Agreement

In consideration of my assignment to CLIENT by DREAMJOB LLC, I agree that I am solely an employee of DREAMJOB LLC for benefits plan purposes and that I am eligible only for such benefits as DREAMJOB LLC may offer to me as its employee. I further understand and agree that I am not eligible for or entitled to participate in or make any claim upon any benefit pan, policy, or practice offered by CLIENT, its parents, affiliates, subsidiaries, or successors to any of their direct employees, regardless of the length of my assignment to CLIENT by DREAMJOB LLC and regardless of whether I am held to be a common-law employee of CLIENT for any purpose; and therefore, with full knowledge and understanding, I hereby expressly waive any claim or right that I may have, now or in the future, to such benefits and agree not to make any claim for such benefits.

As a condition of my assignment by DREAMJOB LLC. I hereby agree as follows:

I will not use, disclose, or in any way reveal or disseminate to unauthorized parties any information I gain through contact with materials or documents that are made available through my assignment at CLIENT or wich I learn about during such assignment.

I will not disclose or in any way reveal or disseminate any information pertaining to CLIENT or its operating methods and procedures that come to my attention as a result of this assignment. Under no circumstances will I remove physical or electronic documents or copies of documents from the premises of CLIENT.

I understand that I will be responsible for any direct or consequential damages resulting from any violation of this Agreement. The obligations of this Agreement will survive my employment by DREAMJOB LLC.

DreamJob LLC - Applicant Acknowledgment

As part of my application for employment through DreamJob LLC, I understand that I may be assigned to various client job sites where physical work or industrial tasks may be required.

By signing below, I acknowledge and agree with the following:

1. I must immediately report any workplace injury, illness, or accident — no matter how minor — to both my onsite supervisor and DreamJob LLC.
2. DreamJob LLC will offer access to appropriate medical evaluations when an incident is reported.
3. If I choose not to report an injury or refuse medical treatment at the time it occurs, I may risk losing eligibility for workers’ compensation benefits, and DreamJob LLC will not be held responsible for delayed claims, unreported injuries, or worsening conditions.
4. If I report an injury and voluntarily refuse offered medical treatment, I agree that: I am not in immediate danger. I am making this decision freely and voluntarily. I release DreamJob LLC and its clients from liability related to the refusal of care.
5. If I later request treatment for a previously unreported condition, it may be denied.

This acknowledgment applies to all current and future job assignments through DreamJob LLC.

Acuerdo de rechazo de tratamiento médico

DreamJob LLC - Reconocimiento del solicitante

Como parte de mi solicitud de empleo a través de DreamJob LLC, entiendo que puedo ser asignado a diversos lugares de trabajo de clientes donde se requiera trabajo físico o tareas industriales.

Al firmar a continuación, reconozco y acepto lo siguiente:

1. Debo reportar de inmediato cualquier lesión, enfermedad o accidente laboral, por leve que sea, tanto a mi supervisor en el lugar de trabajo como a DreamJob LLC. 2. DreamJob LLC ofrecerá acceso a evaluaciones médicas apropiadas cuando se reporte un incidente. 3. Si decido no reportar una lesión o rechazar el tratamiento médico en el momento en que ocurre, puedo correr el riesgo de perder la elegibilidad para los beneficios de compensación laboral, y DreamJob LLC no se hará responsable por reclamos retrasados, lesiones no reportadas o empeoramiento de las condiciones. 4. Si reporto una lesión y rechazo voluntariamente el tratamiento médico ofrecido, acepto que: No estoy en peligro inmediato. Tomo esta decisión libre y voluntariamente. Libero a DreamJob LLC y a sus clientes de toda responsabilidad relacionada con la negativa a la atención médica. 5. Si posteriormente solicito tratamiento para una afección no reportada previamente, podría ser denegado.

Este acuse de recibo aplica a todos los trabajos actuales y futuros a través de DreamJob LLC.

Nombre del solicitante (en letra de imprenta):

• I agree to be and acknowledge the fact that I am a temporary employee who, on my own free will, is choosing to work for DreamJob LLC on a temporary “at will” basis. As such, I agree that I am NOT entering into any contractual agreement with DreamJob LLC regarding any portion of my employment including but not limited to pay, position, employer, length of assignment, or performance, while a temporary DreamJob LLC employee. Furthermore, as a temporary employee, I may be released from any job assignment by either DreamJob LLC or the business to which I am assigned with or without just cause during my employment period with DreamJob LLC. The termination of an assignment does not constitute termination of my employment with DreamJob LLC, and it is my responsibility to seek further assignments by DreamJob LLC.
• I understand that I am an employee of DreamJob LLC and only me or DreamJob LLC can terminate my employment. When an assignment ends, I must report daily to DreamJob LLC office for future assignment options. Failure to do so or to accept my next job assignment will indicate that I have voluntarily quit.
• DreamJob LLC has a very strict “NO DRUG & ALCOHOL POLICY”. It is the policy of DreamJob LLC to maintain a workplace free of illegal drugs and alcohol. DreamJob LLC temporary employees are expected to comply with company rules and regulations which expressly prohibit the unlawful manufacture, use, sale, purchase, transfer or possession of illegal drugs or narcotics, as those terms are used in federal statutes. This includes marijuana, cocaine, heroin and morphine, as well as barbiturates and amphetamines. Legally prescribed medications which do not adversely affect the employee’s work ability, job performance or the safety of that individual or others, are an exception to this policy. I understand that my failure to comply with this Policy will be grounds for my termination. I also understand that I am subject to drug testing at any time and if I refuse to submit to a drug/alcohol test my employment will be terminated.
• DreamJob LLC does not tolerate workplace harassment of any kind in the workplace and I understand that all allegations of workplace harassment will be taken seriously and responded to in an appropriate disciplinary manner up to and including termination of my employment.

• If for some unexpected reason, such as an emergency illness, I cannot make it to work or will be late, I will contact DreamJob LLC as soon as possible so you can call the client and/or find a replacement. My failure to do so may be grounds for dismissal or indicate I have quit.
• Under Texas employment law, if you fail to contact us for reassignment after the completion of an assignment, you may forfeit your right to unemployment benefits. Accordingly, it is to your advantage to always contact our office upon completion of each assignment for additional work.
• Once I have accepted a job DreamJob LLC will instruct me as to the job description and duties. If, at any time while on the job, I am asked to perform functions or duties that are different than originally described I will notify DreamJob LLC immediately.
• I will notify DreamJob LLC immediately if I feel that additional instruction or training is necessary to fulfill my job duties.
• I will notify DreamJob LLC immediately if I incur any physical or technical difficulty performing job duties or tasks on any assignment I am working.
• DreamJob LLC reserves the right to determine the “best fit” for all temporary employees’ job assignments. In the event that DreamJob LLC determines that he/she is not a “good fit” for a particular job assignment, with or without just cause, DreamJob LLC may release me from the appointed job assignment or re assign me to another job assignment. All physical and mental capacities will be evaluated and at the discretion of DreamJob LLC when determining an employee’s “fit” for a job.
• I will report on any unsafe working conditions immediately to DreamJob LLC.
• I will not perform or engage in any job duties or activities that would place me above the ground including the use of chairlifts, ladders, scaffolding or any type of climbing.
• I will not manually lift any objects, boxes, material, etc. which weight exceeds 25 lbs. If requested to do so while on an assignment I will notify DreamJob LLC.
• If I sustain an injury on the job, I will inform the client and DreamJob LLC immediately after the accident. DreamJob LLC will coordinate with me the proper procedure for treatment and reporting the accident. A post-accident drug screen will be completed the same day or within 24 hours of the incident; refusal of the drug screen can result in termination of employment.
• DreamJob LLC pays its employees once a week. Our pay period starts on Wednesday and ends on Friday unless otherwise noted.
• Checks will be ready after 2:00 p.m. on Wednesday following the week worked (unless other arrangements have been made

• I understand that, in order to receive timely payment, I must clock in and out promptly for each day I work. Days that I fail to clock in and out will not be paid until the next paycheck (the following week
• If any DreamJob LLC client to whom I have been assigned offers me a permanent, temporary, or part-time job within 90 days of the end of such assignment, I will promptly notify DreamJob LLC and will not accept such an offer beforehand.
• I understand that all employment opportunities at DreamJob LLC will be presented to me will be temporary assignments. Any and all discussions regarding the possibility of an assignment leading to a full time position should be handled through our office.
• DreamJob LLC has worker’s compensation insurance coverage from Texas Mutual to protect you. You can get more information about your workers’ compensation rights from any office of the Texas Workers’ Compensation Commission, or by calling 1-800-252-7031.
• You may elect to retain your common law right of action, if no later than five days after beginning employment, you notify DreamJob LLC in writing that you wish to retain your common law right to recover damages for personal injury. If you elect your common law right of action, you cannot obtain workers’ compensation income or medical benefits if you are injured.
• Acceptance of all these policies are a condition of my employment with DreamJob LLC. If you fail to comply or agree with any of the terms of these policies, you are ineligible to work for DreamJob LLC. We reserve the right to interpret, change, suspend, cancel, or dispute, with or without notice, all or any part of these policies and procedures.
• I understand that I am expected to complete any job assignment I accept. If I do not complete the assignment then DreamJob LLC can assume I have voluntarily quit. DreamJob LLC employees who leave/abandon/quit by vacating an assigned position without notice or during a designated shift, will be considered to have resigned their employment; the employee will only be paid hours that can be verified by DreamJob LLC and its clients. Temporary employees must report to work on time and work full shifts. Therefore, placements should be chosen carefully and not be accepted unless the employee can complete his/her entire shift. Failure to report to work on time, complete a job assignment, or leave a shift early, without good cause, will result in my immediate release from the job for which I am assigned by DreamJob LLC and/or termination of further employment by DreamJob LLC.
• I have read and fully understand the above statements regarding DreamJob LLC policies and procedures and agree to do the same.

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature Date

I have received information that informs me how to get health care under my employer’s workers’ compensation insurance.

If I am hurt on the job and live in a service area described in this packet, I understand that:

• I must choose a treating doctor from the list of doctors in the network. Or, I may ask my HMO primary care physician to agree to serve as my treating doctor. If I select my HMO primary care physician as my teating doctor, I will call Texas Mutual Insurance Company at (844) 867-2338 to notify them of my choice.
• I must go to my treating doctor for all health care for my injury. If I need a specialist, my treating doctor will refer me to a specialist. If I need emergency care, I may go anywhere.
• Texas Mutual will pay the treating doctor and other network providers for the treatment for my compensable injury.
• I may have to pay the bill if I get health care from someone other than a network doctor wothout prior network approval.

Knowingly making a false workers' compensation claim may lead to a criminal investigation that could result in criminal penalties such as fines imprisonment.

 

Department of the Treasury Internal Revenue Service

Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Give Form W-4 to your employer. Your withholding is subject to review by the IRS.

TIP: Consider using the estimator at www.irs.gov/W4App to determine the most accurate withholding for the rest of the year if: you
are completing this form after the beginning of the year; expect to work only part of the year; or have changes during the year in your
marital status, number of jobs for you (and/or your spouse if married filing jointly), dependents, other income (not from jobs),
deductions, or credits. Have your most recent pay stub(s) from this year available when using the estimator. At the beginning of next
year, use the estimator again to recheck your withholding.

Step 2: Multiple Jobs or Spouse Works
Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will be most accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job

Complete this step if you (1) hold more than one job at a time, or (2) are married filing jointly and your spouse
also works. The correct amount of withholding depends on income earned from all of these jobs.

Do only one of the following.

(a) Use the estimator at www.irs.gov/W4App for the most accurate withholding for this step (and Steps 3–4). If
you or your spouse have self-employment income, use this option; or

(b) Use the Multiple Jobs Worksheet on page 3 and enter the result in Step 4(c) below; or

(c) If there are only two jobs total, you may check this box. Do the same on Form W-4 for the other job. This
option is generally more accurate than (b) if pay at the lower paying job is more than half of the pay at the
higher paying job. Otherwise, (b) is more accurate . . . . . . . . . . . . . . . . . .

Complete Steps 3–4(b) on Form W-4 for only ONE of these jobs. Leave those steps blank for the other jobs. (Your withholding will
be most accurate if you complete Steps 3–4(b) on the Form W-4 for the highest paying job.) 

 

If your total income will be $200,000 or less ($400,000 or less if married filing jointly):

If you want tax withheld for other income you

expect this year that won’t have withholding, enter the amount of other income here.

(a) Other income (not from jobs)

If you want tax withheld for other income you expect this year that won't have withholding, enter the amount of other income here. This may inclide interest, dividends, and retirement income.

(b) Deductions. If you expect to claim deductions other than the standard deduction and

want to reduce your withholding, use the Deductions Worksheet on page 3 and enter the result here.

(c)Extra withholding. Enter any additional tax you want withheld each pay period .

Under penalties of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.

Employee’s signature (This form is not valid unless you sign it

Department of the Treasury Internal Revenue Service

Go to www.irs.gov/FormW9 for instructions and the latest information.

Give form to the requester. Do not send to the IRS.

Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.

1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner’s name on line 1, and enter the business/disregarded entity’s name on line 2

3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check only one of the following seven boxes.

Please write one number per box

Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN If you do not have a number, see How to get a TIN, later.

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

Please review your employee onboarding documents. They contain important information about your employment with DreamJob Staffing.