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Employment Application

Personal Information Name:  
Address:  
City:     State:     Zip:  
Phone:     Email:  
Are you 18 years or older?         
Can you show proof of authorization to work in the United States?         
Have you ever been convicted of a felony that has NOT been legally expunged?         
Position Desired:     Pay Desired:  
Do you desire:         
Date you would be available to start:  
Have you ever applied to NineStar Connect before?         
Refered By:  
Employment History

Add each employer you have had in the last five (5) years. (Add Employer)


Can we contact your former employers?         
Education

For each school, college, or university, trade, technical or business school you have attended, please list the following information.

Name & Location of School Number of Years
Attended
Did you
Graduate
Degree
Recieved
(+)

Describe any specialized training or skills you possess for the position you are seeking:

Personal References   (Add Reference)

All information provided on this Application for Employment is true, correct, and complete to the best of my knowledge. Unless otherwise indicated above, I authorize NineStar Connect and its agents to contact my present and former employers and to investigate all the information contained in this application for employment. I hereby release and forever discharge all persons or companies, and their agents and managerial employees, from any and all claims, known or unknown, on account of or arising out of the disclosure and collection of the requested information concerning my employment.

I understand that if I have made a false statement on this Application and NineStar Connect discovers that false statement after employing me, I may be subject to immediate dismissal.

I understand that this Application will be considered active for ninety (90) days following submission. I further understand that if NineStar Connect does not act favorably upon this Application within that time period, it will be necessary for me to renew my interest by completing another Application for Employment.

Any applicant receiving an offer of employment will be required to submit
to a pre-employment drug and alcohol test.

Our Company uses E-Verify to confirm the employment eligibility of all newly hired
employees. To learn more about E-Verify, including your rights and responsibilities,
please visit www.dhs.gov/E-Verify



Pre-Employment Inquiry Release

In conformance with the Fair Credit Reporting Act and any other state or federal law or regulation, I, the undersigned, hereby consent and authorize the Company, its affiliated companies, its subcontractors and/or its agents (collectively referred to as "the Company") to obtain consumer/investigative consumer reports on me including, but not limited to information concerning my character and general reputation through a consumer reporting agency of its choice in connection with my employment. These reports may be obtained through, but not limited to the following sources: motor vehicle reports, social security number verifications, present and former addresses, criminal and civil history/records, credit history, education, work habits, performance, reasons for termination of past employment from previous employers and any other federal and state and non-public records concerning my past activities. The Company will evaluate the findings of the report(s) in terms of the business necessities of the position and/or their relatedness to the duties of the position.

I hereby authorize without reservation, any party or agency contracted by this employer to furnish the above-mentioned information.

If an adverse employment decision is made due, in whole or in part, to the information contained on the consumer/investigative consumer report, the Company will provide me with a copy of the consumer/investigative consumer report, a summary of my rights under the Fair Credit Reporting Act, and the course of the consumer/investigative consumer report so that I may contact them, if I wish to do so.

I agree that the Company may use such consumer/investigative consumer reports for any and all employment purposes. I agree that this authorization shall remain in effect unless and until revoked in writing by me.

Please provide the following information:


First Name:   MI:   Last Name:  
Other/Former Names:  
Social Security Number:   Date of Birth:  
Driver's License State:
Name as it appears on Driver's License:  
Driver's License No.:  
Applicant's Signature:
(Draw signature in box)
Date: