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1Personal Information

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*Home Phone () -
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*Are you at least 18 years of age and do you have the legal right to work in the United States?

2Felony Information

*Have you been convicted of a felony?



The information I have provided is true and correct to the best of my knowledge. I authorize you to confirm any of the information provided, obtain employment references and personal history and obtain a consumer report which may include a criminal background, DMV and/or credit check information. I also authorize you to disclose any pertinent information concerning me to others, including companies with whom, I may interview or be assigned to. Further, I release all parties and person from any liability that may result from furnishing such information to you, as well as, from the use or disclosure of such information by you.

Any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer of work or my dismissal from employment if I am hired.

I agree that the employment relationship can be terminated at will whether by me or by you, with or without cause, and with or without notice at any time.

In the event, that I am released to be hired permanently by a client of Spherion of Lima, Inc. and/or RKPL, Inc. (d/b/a NSA), and am required to take a pre-employment drug/alcohol test as a condition of employment by that client, I authorize the Spherion of Lima, Inc client, to whom I am assigned ("CLIENT" ) to conduct and release the results of my pre-employment drug/alcohol test to Spherion of Lima, Inc. and/or RKPL, Inc. (d/b/a NSA).

I further agree to release and hold harmless ("CLIENT"), Spherion of Lima, Inc. and/or RKPL, Inc. (d/b/a NSA), its officers, directors, shareholders, employees, agents, representatives, and parent, affiliated, subsidiary and other related companies, from any and all claims, suits, causes of action, liability and damages arising from my submitting to the pre-employment drug/alcohol tests and from the information and/or results obtained by the pre-employment drug/alcohol tests.

Please take a moment to review your application. Indicate that you have read the above statement by entering your initials in the box below. To complete this application, click on the Submit Application button.

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.