Employment Application

An Equal Opportunity Employer

We adhere to a policy of making employment decisions without regard to age, race, color, creed, sex, religion, national origin, marital status, disability/handicap, arrest/conviction record and veteran status. We assure you that your opportunity with CNY Services depends solely upon your qualifications.

Personal Information

Employment Experience

Your present or most recent employer

Previous employer

Education

Special Skills and Qualifications

Please read the following statements before submitting your application

The facts set forth in my application are true and complete. I authorize Staff Leasing to investigate all statements contained in this application and hereby authorize my former employers to furnish all information pertaining to my work record. I hereby release my former employer from all liability on account of furnishing such information to Staff Leasing. I understand that if employed, false statements, omissions or misleading statements on this application could lead to dismissal and agree that Staff Leasing shall not be held liable in any respect if my employment is terminated because of such omissions or false or misleading statements. Staff Leasing is hereby authorized to investigate my employment history, including the contacting of the employers stated in submission of this application.

EMPLOYMENT AND SEPARATION STATEMENT

I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time without prior notice. I understand that I must immediately contact Staff Leasing at their headquarters at 890 Seventh North St. Liverpool, NY 13088, (315) 641-3600 if ever my employment at my current job site is voluntarily or involuntarily terminated.

I understand if hired I will be an employee of Staff Leasing, leased to CNY Services
Staff Leasing has an on-site supervisor for daily instruction.