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We must have professional references of previous employment. Check accept and initial below authorizing your former employers to release employment information and performance information to Select Staff and our authorized Staff. I accept terms Please initial

Do you have any physical/medical limitations that would prevent you from performing required job specifications? None   Yes
If Yes, explain

Have you ever been convicted of a crime or taken deferred adjudication for a crime? Yes   No
If so, what County and State. Explain and give dates.


PLEASE READ AND INDICATE ACCEPTANCE OF TERMS: 1. I do understand that SELECT STAFF is a staffing firm and is my employer while I am on assignment for SELECT STAFF. Assignments are many and varied and are received by SELECT STAFF in unscheduled periods, based on the needs of SELECT STAFF clients. For this reason, I may have periods of time I am not working and I will be waiting on assignments. 2. In order to stay employed and working, I agree to contact SELECT STAFF to notify them that I am completing my assignment for SELECT STAFF. I agree to do this within 24hours of completion of my assignment. 3. I do understand that failure to contact SELECT STAFF upon assignment completion and failure to contact SELECT STAFF at least three times per week after my assignment ends can cause me to be ineligible for unemployment claims. 4. I also understand that if I fail to contact SELECT STAFF as required then SELECT STAFF can assume that I am terminating my employment with SELECT STAFF. I have read sections 1 through 4 of this statement and I do understand all four. I accept terms   Please initial
Today at Select:   Wednesday, Mar 10th
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