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Northern Staffing Services Corporation Application for Employment

Northern Staffing Services Corporation (hereafter “Company/ Northern Staffing”) is an Equal Opportunity Employer.  It is the Company’s policy to afford equal employment opportunity regardless of race, religion, color, national origin, sex, age, marital status, height, weight, disability, or veteran status.  Michigan law requires that a person with a disability or handicap requiring accommodation for employment must notify the employer in writing within 182 days after the need is known. 

Filing this application does not imply that the applicant will be employed, but rather only that the applicant will be considered in competition with other applicants.  A person with a disability or handicap requiring accommodation for completing the application process should notify the Company as soon as possible. 

*Required information you missed will be highlighted. Simply click the RED POP UP and fill in the field.
Error Boxes
First Name : * Middle Name : Last Name : *
Suffix : Last 4 Digitals of SSN : *
Address : * City :   * State : *
Postal Code :
Email : (providing an email will allow us to contact you regarding news and job posting. STRONGLY RECOMMENDED)
Cell : Home : *
Are you a U.S. Veteran? :
Yes No
Attach a Resume : (this online form must still be completed)
Emergency Contact
Name : *   Phone : *
How did you hear about us : *
What date can you start working : Select Date & Time What is your desired position : *
Desired shift :
1st 2nd 3rd
  Able to work :
1st 2nd 3rd
Desired Rate : * Shift Preference :
What week days are you available to work :  
Mon Tues Wed Thu Fri Sat Sun
Are you at least 18 yrs old :
Yes No
Have you completed an application with us before :
Yes No
Are you currently employed :
Yes No
  If yes to the above can we contact your current employer :
Yes No
Are you able to perform the duties required of the position for which you are applying :
Yes No
How would you get to a job? :
  Own vehicle   Ride   Share Vehicle   Other *
Do you have an ACT WorkKeys Assesment?
Yes No
Have you ever been convicted of a crime? :
Yes No
If YES please provide for each conviction (s), the nature of the offense(s), the date of your conviction(s) and your sentence(s). For each crime please specify if it was a felony or misdemeanor.
Are there any felony charges pending against you? :
Yes No
If yes, please explain.
Complete the following only if you wish to apply for a position requiring a driver’s license.
Drivers licence Number :
Has your driver's license ever been revoked, suspended, or restricted?
Yes No
If yes, for what reason and for how long?
List any moving violations during the last three (3) years.
Work Experience (Please list your work experience with your most recent first)
Employed From : Select Date & Time   To Select Date & Time   Position :   Salary :
Company Name : Address :
City : State : Phone :
  First Name   Last Name    
Supervisor :  
May we contact this employer? :
Reason for leaving :
Resigned   Terminated   Laid-Off
Other :
Dates Employed From : Select Date & Time   To Select Date & Time   Position : Salary :
Company Name : Address :
City : State : Phone :
  First Name   Last Name    
Supervisor :  
May we contact this employer? :
Reason for leaving :
Resigned   Terminated   Laid-Off
Other :
Dates Employed From : Select Date & Time   To Select Date & Time   Position :   Salary :
Company Name : Address :
City : State : Phone :
  First Name   Last Name    
Supervisor :  
May we contact this employer? :
Reason for leaving :
Resigned   Terminated   Laid-Off
Other :
    First Last
Name : * *
Phone : *
Relationship : * Years Known : *
    First Last
Name :
Phone :
Relationship : Years Known :
    First Last
Name :
Phone :
Relationship : Years Known :
    First Last
Name :
Phone :
Relationship : Years Known :
Attended From : Select Date & Time * To Select Date & Time * Graduated :   Degree Recieved : *
Name of School : * Location : *
Attended From : Select Date & Time   To Select Date & Time   Graduated :   Degree Recieved :
Name of School : Location :
Attended From : Select Date & Time   To Select Date & Time   Graduated :   Degree Recieved :
Name of School : Location :
Industrial Skills
General Assembly
PC Boards
CNC Lathe
CNC Mill
CNC Maintenance
CNC Operator
CNC Programmer
CNC Set-Up
CNC Language
Manual Lathe
Manual Mill
Die Maker
Die Setter
Drill Press
Saw Operation
Saw Operation Type
Screw Machine
Tool Maker
Machinery Operation
Braze Operator
Metal Stamp Op. 150-200 Tons
Metal Stamp Op. 300+ Tons
Injection Mold
Machine Operator Type
Plastic Mold
Print Press
Fiberglass Experience
Foundry Experience
Other Trade
Grinder : Rough
Grinder : Finish
Grinder : ID/OD
Sheet Metal
Welder : Arc
Welder : Mig
Welder : Spot
Welder : Tig
Welder : Other
Welder : Metal Type
Blue Print Reading
Line Supervisor
Lead Man
Shift Supervisor
Pallet/Hand Jack
General Warehouse
Inventory Control
Shipping Receiving
Retail/Food Service
Food Server
Medical Records
Carpenter : Framing
Carpenter : Finish
Construction : Blue Prints
CDL Type (A,B,C)
Chauffeur License
Operator's License
Mechanic : Type
Technician : Type
Land Surveyor
Electrical : Helper
Electrical : Journeyman
Electrical : Master
Law Enforcement
Mechanical Design
Tools : Calipers/Micrometers
Tools : Ruler Reading
Tools : Gauges
Cardboard Box
Farm Work
Furniture Mover/Moving Company
General Labor
Landscaping Company
Commercial Laundry
Masonry : Mason
Masonry : Masonry Asst.
Masonry : Concrete
Paint : Auto
Paint : Commercial
Paint : Industrial
Insulation : Cellulose, Fiberglass
Shop Math
Union Experience
Security Guard
Clerical Skills
Balance Regulator
Bank Reconciliation
General Ledger
Accounts Payable
Accounts Receivable
Consum Loans
Loan Processor
Mortgage Clerk
Mortgage Loan
1-3 lines
4-9 lines
10+ lines
Administration Assistant
Claims Processor
Data Entry
Legal Assistant
Mail Room
Medical Terminology
New Accounts
Executive Assistant
Office Manager
Customer Service
Speed Writing

In exchange for the consideration of my employment application by Northern Staffing, in the event that I become an employee of Northern Staffing, I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the assignment applied for or any other assignment, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time nor other Northern Staffing practices, shall confer any right to remain an employee of Northern Staffing or to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President of Northern Staffing.  Both the undersigned and Northern Staffing may end the employment relationship at any time, without specified notice or reason.  If employed, I understand that Northern Staffing may unilaterally change or revise the benefits provided to me, or the policies and procedures applicable to me and such changes may include a reduction in the benefits I am entitled to. 

I certify that all of the information furnished on this Application is true, complete and correct.  I understand and agree that any falsification, misrepresentation or omission of fact, either on this Application or during the pre-hire process, may result in (1) my not being offered employment, or (2) dismissal at any time from the service of Northern Staffing, if employed.
I understand that consideration for employment at Northern Staffing is conditional upon a review of my qualifications, work history, references, etc.  I authorize Northern Staffing to request and obtain verification that the information given by me on this Application is true, accurate and complete.  I understand that such verification may include, but may not be limited to background information pertinent to the position for which I have applied, verification of education, verification of employment history, investigation of criminal history, etc.  I therefore authorize my current and all previous employers to cooperate with Northern Staffing, and to release, on a confidential basis, any information they may have concerning me, including information in my personnel record or otherwise known to them, to Northern Staffing, in connection with my application for employment with Northern Staffing.  I specifically release from liability any current or former employer(s), its agents, representatives, employees, officers, directors, etc., for or on account of their providing/disclosing such information to Northern Staffing.
I understand and agree that my employment and compensation is for no definite period and may, regardless of the time and manner of payment of my wages and salary, be terminated at any time by me or the Company, with or without cause, and with or without any previous notice.  I also understand and agree that the Company has the right to unilaterally modify and/or terminate any policies, practices, procedures and standards it has adopted or implemented, to the extent not prohibited by law.  I acknowledge that no Company employee nor representative, other than the President, has either the power or authority to enter into any agreement for employment for any specified period of time, or to make any representations or agreements contrary to any of the foregoing, unless that agreement is in writing and is signed by the President.  I understand that any prior representations, promises, contracts or statements made by or on behalf of the Company are expressly superseded by the foregoing. 
The Immigration Reform and Control Act of 1986 states that employers must require all persons hired to submit documents to the employer showing their identity and their right to be lawfully employed in the United States.  It also requires that the employee complete and sign a government form to this effect.  I understand that if hired by Northern Staffing, I will timely furnish documents for inspection that verify my identity and that I am legally permitted to work in the United States.  Furthermore, I understand that my employment will be terminated if I fail to timely provide the necessary documents.
I understand that (1) Northern Staffing has a drug and alcohol policy that provides for pre-employment screening as well as screening/testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of screening/testing under such policy.  I further understand that continued employment may be based on the successful passing of random job-related physical and/or drug or alcohol examinations.

Any employee who sustains a work related injury at a job site which they have been assigned will be sent to our company sponsored medical facility to receive treatment and will be tested for the presence of drugs and alcohol.  The drug and alcohol test is mandatory, and refusal by an employee shall result in disciplinary action, up to and including termination of employment.  In addition, any employee who has a positive result to a urine drug test will be subject to disciplinary action, up to and including termination of employment.  Also, in accordance with worker’s compensation law any employee found to under the influence of drugs or alcohol during the course of employment may be disqualified from receiving any benefits from Northern Staffing and/or its worker’s compensation carrier.

I acknowledge Northern Staffing as my employer, and any assignment I am placed on is a temporary assignment.  I understand and agree that Northern Staffing may end my assignment at any time.  I agree to abide by the guidelines outlined in the orientation pack that I receive from Northern Staffing.

I understand that it is my responsibility to remain in contact with Northern Staffing on a weekly basis either via telephone, email or in person, regarding my availability for work.  Failure to do so may result in my application being deemed “inactive.”

I agree to notify Northern Staffing of my continued availability to work within 7 days after completion of each assignment.  I understand that failure to do so will constitute a voluntary quit that will affect my eligibility to collect unemployment benefits should I seek unemployment compensation following the completion of such assignment.

I understand that I will not be paid unless and until I present a time card signed by both the client and myself to Northern Staffing (by noon each Monday), unless Northern Staffing has made other arrangements with the Client.

I have reviewed my Application and Addendum; by clicking the box below I authorize Northern Staffing to accept and process my application and certify that the Application and Addendum are complete and accurate.

I have reviewed my application/addendum;by signing I understand the contents of the application/addendum.

Accept Terms & Agreement