Job Listings

Step 1 of 11

Background Check Authorization
Name*
First Middle Last
Former Name(s) and Dates Used
Current Address:*
Street Address Apt./ Lot City State ZIP Code
How long have you lived at this address?
Years
Months
Previous Address
Street Address Apt./ Lot City State ZIP Code
Previous Address
Street Address Apt./ Lot City State ZIP Code
Social Security Number*
Cell Phone #*
Home Phone #*
License Number*
State*
The information contained in this application is correct to the best of my knowledge.
I hereby authorize Aggressive Hiring Group and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Aggressive Hiring Group or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Aggressive Hiring Group and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth.
Electronic Signature*
Date*
Notice to California, Minnesota, and Oklahoma Residents:
Please check the box below if you wish to receive a copy of a consumer report that is requested.
- I wish to receive a copy of any Background Check Report on me that is requested.

Acknowledgement and Authorization of Background Screening Policy:
SELECT ONE OF THE FOLLOWING:
CHOOSE EITHER A OR B*
A. I understand and hereby authorize that Aggressive Hiring Group can/will run a background screen on me. This background screen can/will be records dating all the way back to my birth and may include but not limited to the following areas: Verification of Social Security number, credit reports, current and previous residence, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any other public record.

I further hereby acknowledge that I do not have any felonies, warrants, unpaid tickets, etc. on my background and that all information given to Aggressive Hiring Group is true on my behalf to the best of my knowledge. I also understand that if for any reason my background comes back with any felonies, warrants, unpaid tickets or anything that limits me from a job and I have NOT been truthful about my background they have the right to deny, revoke or terminate my employment with the company. This means, but is not limited to any felonies; warrants or unpaid tickets found when running my background.

B. I hereby acknowledge I cannot sign the above statement do to the fact that I do have felonies, warrants, unpaid tickets, etc. on my background. I do still understand and authorize that Aggressive Hiring Group can/will run a background screen on me. This background screen can/will be records dating all the way back to my birth and may include but not limited to the following areas: Verification of Social Security number, credit reports, current and previous residence, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any other public record.
- A
- B
Electronic Signature*
Date*

PAYROLL WITHHOLDING CONSENT FORM
I understand that I have accepted employment with T & A STAFFING, and understand that I may have up to $50 deducted from my pay to offset the cost of CRIMINAL HISTORY INVESTIGATIONS, DRUG SCREENING, and other processing required for my assignment. I understand this deduction will occur in TWO steps, with 1/2 the amount being held from my first check and 1/2 being held from my second check. These TWO deductions will only be required for my first assignment, regardless of how many additional assignments.
By signing this consent form I am granting T & A STAFFING SOLUTIONS my permission to deduct ANY money I may owe them during my employment or after my release from the company. This may include but not limited to: 1)Cell phones, Laptops, Tablets, etc. 2)Uniforms, Badges, Gloves, Vests, Boots, or Protective Gear 3)Advances on Payroll or Loans 4)Damage to Equipment/Property or Charges of Personal Use of Phones, Internet, and or T & A ACCOUNTS 5)Background/Drug Test fee up to $50
I also understand that upon separation from T & A STAFFING SOLUTIONS. I am required to return all company property and/or cash that may be in my possession.
Print Name*
First Last
Electronic Signature*
Date*

DISCHARGE/DISPLINARY ACTIONS
CLASS A VIOLATIONS (DISCHARGE)

Sleeping on the job

No call/ No show

Using clients Internet

Confidentiality breach

Leaving job site unattended and without proper authorization

Theft

Falsifying logs or records

Reporting to work under or in possession of non- prescribed controlled substance (drugs or alcohol)

Willful destruction of THE COMPANY equipment.

Creating a client complaint.

Consumption of alcohol, before shift or during. Also shift if still on job premises.

Insubordination; i.e.: Showing disrespect to a supervisor, manager, or client by arguing or cursing at them.

Fighting/ creating a disturbance while on a client/ THE COMPANY PROPERTY

SEXUAL HARRASSMENT

In possession of a concealed weapon whether you have a CCW or not while on job premises.

Three (3) unexcused call offs in a thirty (30) day period.

Reporting to work late or not calling off to a on duty supervisor at T & A STAFFING twice in a thirty (30) day period.

CLASS B VIOLATIONS (DISCIPLINE)

Texting and unauthorized cell phone usage.

1st offence for reporting late.

1st offence for not calling off to an on duty T & A STAFFING SUPERVISOR.

Two (2) unexcused call offs in a thirty (30) day period.

Failure to submit incident reports.

Visiting a job site while off duty.

Poor attitude or lack of cooperation.

Print Name*
First Last
Date*

Electronic Signature*
Date*

CALLING IN/OFF RULES AND EMPLOYMENT OFFERS
It is very important to be present and on time for your scheduled shift. As a T&A Staffing employee, you may not miss any work within your first 60 days employed with us unless approved by a T&A Staffing Recruiter. If you do miss work within your first 60 days and it is unapproved your employment with T&A Staffing can/will be terminated. This includes but is not limited to family illness, personal illness, medical conditions, funeral/death, car problems, etc.

AFTER THE 60 DAY PERIOD FOR ALL CALL OFFS you MUST CALL T & A STAFFING AT (734)785-8968, PLEASE FOLLOW THE PROMPTS ON HOW TO CALL OFF FOR YOUR SCHEDULED SHIFT.

DO NOT FOR ANY REASON CALL YOUR JOB SITE TO CALL OFF. WE ARE YOUR EMPLOYER. YOU REPORT ALL CALL OFFS TO STAFFING

*Failure to call off for your shift can/will result in your release from the company as a voluntary quit*

*If released from one of our job sites you must call within a 7-day period from your release date to let us know that you are available for work. Failure to call within the 7-day period will result in your release from the company as a voluntary quit.

If for any reason, you work for us for multiple clients and are released from 2 or more job sites in a 6 month period, we do have the right to no longer place you within any of our job opportunities per our company policy.
Print Name*
First Last
Electronic Signature*
Date*

RELEASE & AUTHORIZATION
I hereby authorize any release of personal information requested by T&A Staffing Solutions, or other representatives, regarding my employment with T&A Staffing Solutions. This includes but not limited to unemployment claims, garnishments, child support claims, verification of employment, etc.

Upon signing this form, I releaseT&A Staffing Solutions, from any and all liability resulting from such inquires and disclosures of information.
Print Name*
First Last
Electronic Signature*
Date*

EMPLOYEE/ CLIENT CONFIDENTIALITY AGREEMENT
In consideration of and as a condition of my employment by T&A Staffing and for by companies which it owns, controls, or is affiliated with, and their predecessors and successors (the "Company''), and the compensation previously, now and hereafter paid to me for such employment directly or through an agency as well as other agreements involving the Company which I acknowledge will benefit me, I hereby agree as follows, and confirm my compliance with the following during the entire course of employment with the Company or engagement in any other capacity whatsoever, whether as a consultant, independent contractor or in any other relationship:

CONFIDENTIALITY: I agree to hold in strictest confidence and not to disclose, make any use of, except for the benefit of the Company, lecture upon or publish, at any time either during the term of or subsequent to my employment, any of the Company's Proprietary Information (as defined below) which I may produce, obtain or otherwise acquire during the course of my employment, except as the Company may otherwise consent to in writing in its sole and absolute discretion. I further agree not to deliver, reproduce or in any way allow such Proprietary Information, or any documentation relating to such information, to be delivered or used by any third parties without the specific written direction or consent of a duly authorized representative of the Company. The term "Proprietary Information" shall mean any and all trade secrets, confidential knowledge, data or any other proprietary information pertaining to any business of the Company or any of its clients, customers or consultants, licensees or affiliates. By way of illustration but not limitation, "Proprietary Information" includes ( a) ideas, improvements, discoveries, trade secrets, processes, data, programs, source code, web site designs, web site processes, knowledge, know-how, designs, techniques, formulas, test data, computer code, complain.ts, complaint processes and analysis, security procedures and processes, passwords, user ids, customer information, affiliate information, customer lists, affiliate lists, other works of authorship and designs whether or not patentable, copywright-able, or otherwise protected by law, and whether or not conceived of or prepared by me, either alone or jointly with others (b) information regarding research, development, new products and services, marketing plans and strategies, merchandising and selling, business plans, strategies, forecasts, projections, profits, investments, operations, financing, records, budgets and financial statements, licenses, prices and costs, suppliers and customers; and (c) identity, requirements, preferences, practices and methods of doing business of specific parties with whom the Company transacts business, and information regarding the skills and compensation of other employees of the Company and independent contractors performing services for the Company.

THIRD PARTY INFORMATION: I understand that the Company, from time to time, may enter into agreements with other parties which impose obligations or restrictions on the Company regarding ideas/decisions made during the course of the work under such agreements or regarding the confidential nature of such works, or otherwise receive from third parties confidential or proprietary information ("Third Party Information") subject to a duty on the Company's part to maintain. the confidentiality of such information and to use it only for certain limited purposes. During the term of my employment and thereafter, I agree to be bound by all such obligations and restrictions, will hold Third Party Information in the strictest confidence, will not disclose (to anyone other than Company personnel who need to know such information in connection with their work for the Company) or use, except in connection With my work for the Company, Third Party Information unless expressly authorized by the Company in writing, and will otherwise take all action necessary to discharge the obligations to the Company arising in connection with such Third Party Information.

RETURN OF COMPANY PROPERTY: I acknowledge and agree that all files, accounts, records, materials, documents, drawings, sketches, designs, diagrams, models, blue-prints, plans, specifications, manuals, books, forms, receipts, notes, reports, memorandum, studies, data, calculations, recordings, catalogs, compilations of information, correspondence, e-mails, financial data, marketing data, password data, user id data, customer data, affiliate data, and all copies, abstracts and summaries of the foregoing, instruments, tools and equipment and all other physical items related to the Company or to my employment with the Company, other than merely personal items, whether of a public nature or not, and whether prepared by me or not, are and shall remain the sole and exclusive property of the Company and shall not be removed from the premises of the Company, except as required in the course of employment by the Company, without prior written consent of the Company in each instance. In the event of termination of my employment with the Company for any reason whatsoever, I agree to promptly surrender and deliver to the Company all of the foregoing property, and I will not take with me any description containing or pertaining to any Proprietary Information which I may produce or obtain during the course of my employment.

TRADE SECRETS OF OTHERS: I represent that my performance of all the terms of this Agreement and as an employee of the Company does not and will not breach any agreement to keep in confidence Proprietary Information, knowledge or data acquired by me in confidence or in trust prior to my employment with the Company, and during my employment by the Company, I will not improperly use or disclose to the Company, or induce the Company to use, any confidential or proprietary information or material belonging to any previous employer or other parties. I have not brought and will not bring onto the premises of the Company or use in the performance of my responsibilities at the Company any unpublished documents or any property belonging to any previous employer or any other person to whom I have an obligation of confidentiality unless consented to in writing by that previous employer or person. I agree not to enter into any agreement either written or oral in conflict with this Agreement.

ENFORCEMENT: I understand and agree that in the event of a prospective or actual breach of this Agreement by me, damages would not be an adequate remedy to compensate the Company.for the losses suffered as a result of such breach. Accordingly, in addition to all other rights and remedies the Company has at law or in equity, in the event of a threatened or actual breach of any of the terms and provisions of this Agreement, the Company shall be entitled to prevent or terminate such anticipated or actual breach, without the necessity of proving actual damages or other undertaking in connection with any such action, provided that nothing in this Agreement shall be construed to limit the damages otherwise recoverable by the Company in any such event. In addition, the Company shall have the right to inform any person, company, organization or business entity, and the principals of the foregoing, and any other third parties that the Company reasonably believes to be receiving or intending to receive from me any Proprietary Information in violation of the terms of this Agreement, that participation by such entity or persons with me in activities in violation of this Agreement may give rise to claims by the Company against such entity, persons or third parties.

PURPOSE AND INTENT: I acknowledge and agree that this Agreement does not constitute an agreement of employment and that nothing in this Agreement shall confer any right upon me with respect to my employment by the Company, including, without limitation continuation of such employment, and to the extent there is employment With Company such employment shall only be construed to be "at will."
Print Name*
First Last
Electronic Signature*
Date*

TELEPHONE, INTERNET AND EQUIPMENT ABUSE
Phone Abuse Is:

Conversations with friends, family or co-workers that are not considered an emergency or pertain to current work related issues

Discussing personal business on company time

Texting while on the job for any reason other than an emergency

ANY PERSONAL CALLS SHOULD BE MADE WHILE OFF THE CLOCK!!!
Equipment abuse is:

Using any equipment for personal use

Handling equipment any other way than you were trained to do so

Excessively misusing any equipment on the job site

Internet abuse is:

Using social media to criticize or talk badly about your employer

Using the Internet to surf the Web, email, or play games

ANY PERSON FOUND NOT ABIDING BY THESE RULES COULD BE IMMEDIATELY RELEASED FROM THE ESTABLISHMENT. WE GREATLY APPRECIATE YOUR COMPLIANCE WITH THESE ISSUES AND THANK YOU FOR YOUR ADHERENCE TO THEM.

Name*
First Last
Electronic Signature*
Date*

Acknowledgement and Authorization of Drug Testing Policy
I understand that T&A Staffing maintains a DRUG FREE workplace, If I am applying for work or am already employed with the company, I understand that I may be required to submit to a DRUG/ALCHOHOL TEST, Additionally, I may be required to submit to a random DRUG/ALCHOHOL TEST at any time during the course of my employment or after, especially after an accident has occurred on the job site.

I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement
Print Name*
First Last
Address*
Street Address Apt./ Lot City State ZIP Code

Phone
Electronic Signature*
Date*

Healthcare Enrollment/ Wavier Form:
Employee Name*
First Last
Employee Electronic Signature*
Date*

OptiMed Minimum Essential Coverage (MEC}*
CHOOSE YES OR NO
Yes, I will be enrolling(if enrolling dependents you must fill out the complete OptiMed enrollment form).
No, I will not be enrolling and will be waiving coverage.
IF YOU SELECTED YES, THEN PLEASE CHOOSE FROM ONE OF THE FOLLOWING:
Note:
*A fee of $125.00 per week will be applied to each employee.

Failure to return the Enrollment/Waiver Form or if no proof of existing coverage is produced, he or she may be automatically enrolled into the MEC plan for 1/l/2016 as per the guidelines set forth in the Affordable Care Act (ACA} PPACA HR3590.

Perthe Affordable Care Act (ACA) PPACA HR3590 "Obamacare", as of 1/1/14, by law, if you waive or opt out of your employer sponsored healthcare plan, you will not be eligible for any subsidies or tax credits if your healthcare is purchased inside the State of Michigan's healthcare exchange (www.Healthcare.gov).

A Section 125 payroll deduction is a pretax deduction from your paycheck that allows you to save money on your portion of the healthcare that you are enrolled in thru your employer. Only medical premiums can be taken out of an employee's paycheck pretax thru a Section 125 payroll deduction.

**Reference the Affordable Care Act (ACA) PPACA HR3590 Section 4980H "Obamacare", for employee/employer contribution levels based on the scheduled 40 hour work week.

This document is for reference only. All employer requirements are based on Prudential Security Inc, interpretation of the Affordable Care Act (ACA) PPACA HR3590. Please refer to the complete benefit descrlption that comes with your ID cards for all benefits and coverage's. Guidelines, rates, benefits and regulations are based on information outlined under the Affordable Care Act (ACA) PPACA HR3590. All plaTls and benefits are subject to change based on any changes that are required by law to-keep in compliance with the Affordable care Act (ACA) PPACA HR35_90.

PAYCHECK INFORMATION SHEET

Direct deposit (see direct deposit form on next page) If you do not have a bank account you may go to www.greendot.com/GetACard and sign up to receive a pay card, then fill out direct deposit form attached accordingly.

Employees may pick up their checks from our office located at: 20600 Eureka Rd., Suit 314 Taylor, MI. 48180 on payday (Fridays) or anytime after Monday-Thursday from 8:30 a.m.-5:00 p.m.

Please send all completed direct deposit forms that are not filled out at the time of your initial application to: mboylan@customtastaffing.com. Any questions regarding direct deposit forms you may contact Megan at (734) 785-8968.
Electronic Signature*
Date*

Apply in Michigan

Step 1 of 11

Background Check Authorization

The information contained in this application is correct to the best of my knowledge.

Acknowledgement and Authorization of Background Screening Policy:

PAYROLL WITHHOLDING CONSENT FORM

DISCHARGE/DISPLINARY ACTIONS

CLASS A VIOLATIONS (DISCHARGE)

CLASS B VIOLATIONS (DISCIPLINE)

CALLING IN/OFF RULES AND EMPLOYMENT OFFERS

RELEASE & AUTHORIZATION

EMPLOYEE/ CLIENT CONFIDENTIALITY AGREEMENT

TELEPHONE, INTERNET AND EQUIPMENT ABUSE

Phone Abuse Is:

ANY PERSONAL CALLS SHOULD BE MADE WHILE OFF THE CLOCK!!!

Equipment abuse is:

Internet abuse is:

ANY PERSON FOUND NOT ABIDING BY THESE RULES COULD BE IMMEDIATELY RELEASED FROM THE ESTABLISHMENT. WE GREATLY APPRECIATE YOUR COMPLIANCE WITH THESE ISSUES AND THANK YOU FOR YOUR ADHERENCE TO THEM.

Acknowledgement and Authorization of Drug Testing Policy

Healthcare Enrollment/ Wavier Form:

OptiMed Minimum Essential Coverage (MEC}*

PAYCHECK INFORMATION SHEET

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