Pre-Employment Application Please fill out the form below to the best of your knowledge. 1. What position(s) are you applying for? 2. Do you have a resume? YesNo 3. Have you ever applied with Master Staffing before? YesNo If yes, what date(s)? 4. How did you hear about Master Staffing? 5. Are you 18 years or older? YesNo 6. Do you have reliable transportation to work every day? YesNo If yes, select mode of transportation: CarRideBusBikeWalkOther 7. Some of our positions require repetitive lifting of up to 50lbs. Is this something that you are capable of doing? YesNoUnsure If unsure, please explain: 8. Do you have proper identification that proves that you are eligible to work in the United States? YesNo 9. Are you willing to take a drug screen according to our policy? YesNo 10. Do you have any criminal convictions?* YesNo If yes, please explain (Offense, Year, County & State): *A conviction itself does not constitute an automatic bar to employment. The seriousness of the crime and the date of conviction will be considered. Previous Employment 1 Time of Employment: Name of Employer: Position Held: Reason for Leaving: Previous Employment 2 Time of Employment: Name of Employer: Position Held: Reason for Leaving: Previous Employment 3 Time of Employment: Name of Employer: Position Held: Reason for Leaving: By submitting this form, I hereby declare that all statements contained in this pre-application are true and correct, and understand that false or inaccurate information in the pre-application will be the basis for termination. I authorize you and all former employers, and others given by me as reference, to answer all questions and to give all information in connection with this pre-application or in any way concerning me. I hereby authorize Master Staffing LLC to investigate my background inclusive of any criminal records. I also agree to submit a drug test upon request or as specified by Master Staffing LLC. I authorize Master Staffing LLC to release the information contained herein including but not limited to (Work History, Drug Test Results, Criminal Background Checks, References, and other related employment data) to Master Staffing LLC Customers/Clients, other firms, government agencies, and others upon request. I further agree that if employed by Master Staffing LLC, that if I ever make any claims against you for personal injuries, upon your request, I shall submit to drug screens and examination by physicians of your selection. I understand that Master Staffing LLC, has the right to terminate my employment at any time without any liability to me except wages and/or salary earned by me at the date of such termination. I understand that this pre-application is for employment consideration by Master Staffing LLC and in no way guarantees a placement, assignment or employment with Master Staffing LLC or it's customer client companies. Please leave this field empty.