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  • Employment Experience

    Starting with your most recent employer, please provide the following information.
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  • EQUAL EMPLOYMENT OPPORTUNITY

    Our Company is an Equal Employment Opportunity Employer. Applicants will be recruited, selected and assigned without regard to race, color, religion, national origin, gender, age, disability, marital or veteran status, sexual orientation or any other characteristic protected by law, except where bona fide occupational qualification exists. This policy applies to all employment decisions including recruitment, selection, job assignment, compensation, promotion, demotion, benefits, training, discipline and termination. I understand that no question on this application is used to limit or eliminate any applicant from consideration for employment on any basis prohibited by local, state or federal law.

    AUTHORIZATION AND UNDERSTANDING

    I further understand that my employment is conditional until such time as the results of any pre-employment drug testing or background checks, if any is required by the Company, and is further conditioned upon verification of the information contained in this application. I also understand I may be required to submit to a medical/physical examination in accordance with applicable laws. I further attest that all of the information in my application and/or verbally supplied to the Company is true and correct information. I understand that I can be disciplined or terminated by the Company for providing inaccurate of false information. The Company is an Equal Opportunity Employer and therefore complies with all applicable laws prohibiting discrimination, retaliation, and harassment related to race, color, religion, sex, national origin, citizenship, age, marital status, sexual preference, disability, or handicap or any other protected class or characteristic under applicable law. I will inform the Company about any actual or perceived violations of the law so that the Company can take appropriate action to resolve the matter.

    EMPLOYMENT AT WILL

    I understand that any employment with the Company will be "at will" and may be terminated with or without cause, and with or without notice, at either my or the Company's option. I further understand and agree notwithstanding the above, that, no manager, representative, agent or associate of the Company other than its President, has now or has had in the past any authority to enter into an agreement for employment for any specified period of time or to make any agreement which is contrary to or a modification of the above described employment for any specified period of time or to make any agreement which his contrary to or a modification of the above described employment relationship, and that any such agreement or representative must be in writing and signed by both myself and the President of the Company in order to be effective.

    DISCRIMINATION AND HARASSMENT

    Our Company is committed to providing a professional work environment free of harassment and unlawful discrimination. All forms of harassment and unlawful discrimination including, but not limited to, comments, jokes, gestures or conduct related to race, color, religion, sex, age, disability, national origin, sexual orientation or veteran status are strictly prohibited and are a violation of Company policy. Anyone found to be participating in any form of harassment or unlawful discrimination will be subject to disciplinary action up to and including termination of employment.

    Sexual Harassment is defined by the Equal Employment Opportunity Commission as: "Unwelcome sexual advances, requests of sexual favors and other verbal and physical conduct of a sexual nature constitute sexual harassment when (1) submission to such conduct is made either explicitly or implicitly a term or condition of an individual's employment, (2) submission to or rejection of such conduct by an individual is used as the basis for employment decisions affecting such individual, or (3) such conduct has the purpose or effect of substantially interfering with an individual's work performance or creating an intimidating, hostile, or offensive working environment." This type of conduct may include jokes, vulgar language, sexual innuendos, pornographic pictures, sexual gestures, physical grabbing or pinching and other unwelcome or offensive physical touching or contact. Conduct such as this, whether of a sexual nature or otherwise, is a violation of company policy and will not be tolerated.

     Any employee who feels he or she has been the subject of harassment or unlawful discrimination should notify their supervisor immediately. If the employee does not feel comfortable notifying the supervisor they can contact the Risk Management Department or Human Resources at the Corporate Office at (855) 625-0005. All claims of harassment will be investigated immediately upon notification in as confidential a manner as possible. Employees can report incidents of harassment without fear of retaliation. We will act promptly and vigorously to take appropriate disciplinary action toward any employee found to be engaging in sexual or other unlawful harassment up to and including termination of employment.


    DRUG AND ALCOHOL POLICY

    While on Company premises or on assignment for Company, no employee may use, possess, distribute, sell or be under the influence of alcohol or illegal drugs. The misuse of legally prescribed drugs is also prohibited. I understand the Company may require a drug and alcohol test on a random basis (depending on position), as a client requirement prior to assignment or for reasonable suspicion of drug or alcohol use in accordance with all federal and state regulations. I authorize and consent to such drug testing to determine the presence of illegal drugs or alcohol. I also agree to submit to contagious disease screens upon client request. Any violation of this policy including the refusal to submit to testing will result in termination of employment.

    I also understand the Company requires a drug and alcohol test after every injury/accident, the same day as the injury/accident, even if medical treatment is refused. I understand that failure to be tested after an injury/accident may result in termination of my employment.

    I will hold all parties concerned harmless. This means I will not sue or hold responsible, the parties for any alleged harm to me as a result of the test report, including possible clerical or laboratory error, which interferes with my obtaining a job or continuing employment. I understand the impact of this procedure and authorization and acknowledge that it has been explained to me in a language I understand. I was told that if I have any questions about testing, they would be answered. I understand this is a legally binding document and that Company is sending me for the examination at its own expense.

    CALIFORNIA SICK LEAVE LAW

    The Company uses the "accrual" method in accordance with California's Paid Sick Leave Law (AB 1522). Employees accrue up to 3 days/24 hours of paid sick leave on an annual basis (12 month basis) starting July 1, 2015 and the paid sick leave is provided on the employee's anniversary date. Any unused sick leave is rolled or carried over at the end of the 12 month basis and unused sick leave is not paid out upon termination of employment. Employees will start to accrue 3 days/24 hours on their anniversary date, in their second year of employment which will be added to any rolled or carried over time from the previous year. Sick Time will cap at 6 days or 48 hours. For employees who were not employed through Company prior to July 1, 2015, the first day of employment for the first job that the employee is employed through Company will be the employee's "anniversary date" and the 12 month basis will be measured by the employee's anniversary date. For the employees employed through Company prior to July 1, 2015, the employee's "anniversary date" is July 1, 2015 and the 12 month basis is measured from July 1 through June 30. There is a minimum of 2 hour usage increment unless approved by Company Representative. This policy is not intended to provide lesser or greater paid sick leave beyond what is expressly provided by California laws, including AB 1522 and/or any other city, county, or other codified laws of California, and employees will not be retaliated against for raising questions or concerns regarding such rights.

    EMPLOYEE CONDUCT

    The following are violations of the employee rules of conduct and are subject to disciplinary action up to and including immediate termination of employment:

    • Verbal or physical abuse or violence of any kind on the job or on Company premises.
    • Use, possession, selling, distributing or being under the influence of illegal drugs or alcohol on an assignment or on Company premises or any other violation of the Company drug and alcohol policy.
    • Fraud, theft or any other inappropriate removal or possession of company or client property.
    • Failure to comply with the Company's and the client's safety procedures.
    • Failure to report to an assignment and not notifying Company prior to the start time of the tardiness or absence or any nocall, no-show incident.
    • Walking off an assignment for any reason.
    • Receiving a "poor performance" or "safety violation" report from a client.
    • Any violation of the Company harassment policy.
    • Failure to notify Company within 24 hours of the end of an assignment that you are available for work.

    This list does not include all conduct that may be a violation of the rules of employee conduct. Company reserves the right to decide what conduct is inappropriate and what form of disciplinary action is necessary.

    TEMPORARY JOBS AND DURATION OF EMPLOYMENT

    Company is a Temporary Employment Service and therefore employment is based on our client's needs for labor and whether applicants are qualified and available for the requested temporary labor needs. We recruit and screen candidates that have the potential to fulfill our client's current and potential open positions. Based on your qualifications, you may be offered temporary at-will employment to work at one of our client sites as a temporary or temp to hire position, but you are not guaranteed employment with COMPANY. These jobs are temporary in nature and your at-will employment is temporary in nature. When you are hired for a temporary job, and your temporary job ends, your employment with Company will end on the day that you receive your final paycheck for the temporary job. However, you may be offered future temporary job opportunities and rehired for future temporary jobs.

    Applicant Certification & Agreement

    I hereby declare that all statements and information contained in this application are true, complete and correct. I understand that any false, incomplete or misrepresented information in the application will be a basis for elimination from further consideration for employment or immediate termination of employment at the time it is discovered.

    In consideration for employment with the Company, I hereby authorize my current employer to provide any written and verbal information to evaluate my qualifications for employment. In further consideration of the time and effort in responding to this request, I hereby release my current employer, its associates, officers, director, agents, personnel, attorneys, affiliates, and related entities from any and all claims, liabilities, damages or causes of action in any way arising from the references of information provided as a result of the authorization. I further agree that a copy of the Consent for Release of Information can be supplied to my current employer in lieu of the original. If I resign or if I am terminated, I authorize the Company to use any information in its possession concerning me for reference purposes and/or if legally required to furnish any information, including disclosure of information to any third party, prospective employer, without receiving any prior notice, and I release the Company from any liability in connection with such use or disclosure.

    I understand that this application for employment shall be considered active for a period of time not to exceed 90 days. If I wish to be considered for employment beyond this time period, I will be required to complete and submit a new application.

    I understand the Company uses a dispatch system when filling job assignments. This means a temporary employee must be in communication with branch personnel to be considered for available work assignments. I understand that it is my responsibility to communicate to the branch that I am available for work. I must communicate to the branch that I am available for work within 24 hours, or no later than the next business day, of the end of an assignment. Voicemails left at the branch will not constitute notification of availability. If I do not contact the branch available for work, it may be considered a voluntary resignation and my unemployment benefits may be denied.

    I understand that this application does not constitute a contract or agreement and, if employed, my employment will not be for any fixed period of time. I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge the employee at any time, with or without cause or prior notice. It is further understood that this "at will employment relationship may not be changed by any written document or conduct unless such change is specifically acknowledged, in writing, by the president of the organization. I understand that no supervisor or other representative of the employer is authorized to make any guarantees or assurances to the duration of employment and that no oral or written agreements contrary to the above language are valid unless signed by the president of the organization.

  • READ THE ABOVE CERTIFICATION AND AGREEMENT BEFORE SIGNING.

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