Employment Application Please fill out the application form below and we will contact you right away with more information! Name* First Last Birth Date* MM slash DD slash YYYY Do you have an email address?* Yes No Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Please indicate the position, if any, you are applying for:* Are you eligible to work in the U.S.?* Yes No Have you been convicted of a felony within the last 5 years?*(If you have been convicted of a felony this does not automatically disqualify you from eligibility) Yes No If "Yes" please explain. A conviction will not automatically disqualify you.*Do you have reliable transportation?* Yes No Check Fields of Experience Machine Operation Forklift Commercial Vehicle Concrete Framing Carpentry Sheet Rock Painting Electrical Roofing Plumbing Landscaping/Lawn Maintenance Factory Warehouse Assembly/Production Quality Control Shipping & Receiving Maintenance Housekeeping/Janitorial HVAC Clerical/Data Entry Other ExperienceLicenses or CertificationsSkills & QualificationsPlease list any special skills, abilities, or honors that might me relevant.Emergency ContactsName First Last PhoneName First Last Employment HistoryUpload ResumeMax. file size: 8 MB.Company Name PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country From MM slash DD slash YYYY To MM slash DD slash YYYY May we contact this employer? Yes No Company Name PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country From MM slash DD slash YYYY To MM slash DD slash YYYY May we contact this employer? Yes No Do you have reliable transportation and will you be able to make it to work on-time?* Yes No How far are you willing to travel to get to work?* Less than 5 Miles 5-10 Miles 10-20 Miles Over 20 Miles Do you have a shift preference?*(Check All that Apply) First Shift Second Shift Third Shift Are there days or times you are not available to work?* No Yes Please indicate days/hours you are unavailable to work: Employment preference? (Check all that apply)* Part-Time Full-Time Short-Term Long-Term What kind of job are you looking for? Is there any type of job that you DO NOT wish to do?* No Yes If yes, please explain: What is the minimum hourly start pay you are willing to accept for a position?* How soon are you available to start working?* Do you have any upcoming appointments or obligations that would interfere with your work schedule?* No Yes If YES, please explain: Have you worked for a staffing agency before?* No Yes How did you hear about LSM Staffing? (Check ANY that apply)* Referred by Friend/Family Indeed Job Listing Google Search Facebook / Social Media Craiglist Job Listing Other Advertisment Location Sign Other Terms and ConditionsLabor Support Management, Inc. (DBA: LSM Staffing) is an equal opportunity employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, national origin, marital status, ancestry, citizenship, veteran status, sexual orientation or preference, physical or mental disability, or any other legally protected status. This application will remain active for a period of six (6) months from date of application. To be considered for employment after that time, a new application is required. Applicants may request any reasonable accommodation to enable them to participate in the application process.I certify that the information provided in this application and accompanying resume is true and complete, and I understand that any false information or significant omissions may disqualify me from further consideration for employment and may be justification for dismissal if discovered at a later date. I authorize the investigation of all statements contained in the application and resume. I also authorize the Company to contact my past employers and references. I understand that the Company may request an investigative Consumer Report from a Consumer Reporting Agency and I have specifically authorized such investigation in conjunction with my application for employment. I authorize any person, school, current or past employer, and organizations named in my application or resume to provide the Company with relevant information and opinion that may be useful to the Company in making a hiring decision, and I release such persons and organizations from any legal liability from making such statements. I understand that the Company provides temporary labor to its clients, some of which require pre-employment and random drug screening. I hereby agree to a drug screen examination prior to, or after, an offer, if it is required by the client. I understand that said offer, or continued employment, is contingent upon satisfactory drug screen results. I understand and agree that my employment relationship with the Company if hired is an at-will-employment relationship and may be terminated by me or the Company at any time, with or without cause. I understand that no one can alter the at-will employment nature of the relationship mentioned in this application and that this application is not, and is not intended to be, a contract of employment. By my checking the box below and submitting this application, I hereby acknowledge that I have read and agree to the above statements. Terms And Conditions* I Understand and Agree to the Terms and Conditions CommentsThis field is for validation purposes and should be left unchanged.
