Applicant Information
Employment Position
Position(s) applying for:
Personal Information If yes, please list below?
What document can you provide as proof of citizenship or legal status?
If yes, please describe accommodations required below.
If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
Job Skills/Qualifications Please list below the skills and qualifications you possess for the position for which you are applying:
(Note: Michigan Prime Staffing complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. )
Education and Training
High School
College/University
Vocational School/Specialized Training
Military: If yes, please describe accommodations required below.
Previous Employment
Employer Name:
Employer Name:
Employer Name:
Additional Information: Do you have 5 years of Driving experience? Do you have a valid Drivers License?
Do you have more than two driving violations in the past three years.
Have you ever been asked to resign in the last 12 months
At-Will Employment
The relationship between you and the Michigan Prime Staffing is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Michigan Prime Staffing. No representative of Michigan Prime Staffing has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President. Submit