Application Agreement

Release and Consent

Should this application lead to a video interview with ProfiStaff, LLC, for good and valuable consideration, the receipt of which is hereby acknowledged, I hereby consent to the photographing of myself and the recording of my voice and the use of these photographs and/or recordings singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes. I understand that the term “photograph” as used herein encompasses both still photographs and motion picture footage.

I further consent to the reproduction and/or authorization by ProfitStaff, LLC to reproduce and use said photographs and recordings of my voice, for use in all domestic and foreign markets. Further, I understand that others, with or without the consent of ProfitStaff, LLC may use and/or reproduce such photographs and recordings. I hereby release ProfitStaff, LLC, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies, their directors, officers, agents and employees from all claims of every kind on account of such use.

Confidentiality Agreement

As a condition of any and all future assignments with ProfitStaff, LLC, I hereby agree as follows:

I will not use, disclose, or in any way reveal or disseminate to unauthorized parties any information I gain through contact with materials or documents that are made available through any and all assignments at any Client of ProfitStaff, LLC or which I learn about during such assignment. I will not disclose or in any way reveal or disseminate any information pertaining to CLIENT or its operating methods and procedures that come to my attention as a result of this assignment. Under no circumstances will I remove physical or electronic documents or copies of documents from the premises of any Client of ProfitStaff, LLC.

I further understand that I will be responsible for any direct or consequential damages resulting from any violation of this Agreement. The obligations of this Agreement will survive my employment by ProfitStaff, LLC.

Waiver of Benefits

In consideration of any and all future assignments with ProfitStaff, LLC, I agree that I would be solely an employee of ProfitStaff, LLC for benefits plan purposes and that I am eligible only for such benefits as ProfitStaff, LLC may offer to me as its employee. I further understand and agree that I am not eligible for or entitled to participate in or make any claim upon any benefit plan, policy, or practice offered by any Client of ProfitStaff, LLC, Client parent companies, affiliates, subsidiaries, or successors to any of their direct employees, regardless of the length of any and all future assignments with ProfitStaff, LLC and regardless of whether I am held to be a common-law employee of any Client of ProfitStaff, LLC for any purpose; and therefore, with full knowledge and understanding, I hereby expressly waive any claim or right that I may have, now or in the future, to such benefits and agree not to make any claim for such benefits.

Safety Information Acknowledgment and Agreement

In consideration of any and all future assignments with ProfitStaff, LLC, I acknowledge that I will receive and have access to important safety information as it relates to standard safety practices and policies. I understand that I am expected to read this safety information and familiarize myself with its contents. I do hereby agree to comply with and follow safe workplace practices, and to report any hazardous conditions, or work-related accidents, injuries or illnesses to ProfitStaff, LLC if, and as soon as, it occurs, but no later than the end of the work day, on which the work-related accident or injury occurred. I understand that ProfitStaff, LLC has an acceptable Worker’s Compensation Insurance Policy and that I must report promptly any work-related accidents, injuries or illnesses to ProfitStaff, LLC in order to receive any Worker’s Compensation benefits. I understand the procedures for how to report an injury and that all necessary information as it relates to receiving medical treatment for a work-related accident, injury or illness has been posted by ProfitStaff, LLC and is readily available. I acknowledge and understand that treatment received outside of these procedures being followed is not compensable unless authorized by ProfitStaff, LLC’s insurance carrier prior to the treatment date. I understand that according to Workers’ Compensation Law, my compensation benefits could be reduced or denied for any accident, injury or illness that occurs because of failure to follow established safety procedures.

I further understand and agree that nothing herein or in the safety information provided by ProfitStaff, LLC constitutes an employment contract or promise of continued employment and that ProfitStaff, LLC may change its policies regarding safety at any time.

Background Check Release Form


Important – Please read carefully before signing:  I understand and agree that:

An investigative consumer report may be obtained in accordance with all applicable state and federal law at any time during the application process and thereafter during your association with the organization.Before any adverse action is taken, based in whole or in part on the information contained in the consumer report, you will be provided a copy of the report and a summary of your rights under the Fair Credit Reporting Act.

I understand that, as a condition of my consideration for employment with ProfitStaff, LLC, or as a condition of my continued employment with ProfitStaff, LLC, an investigation of my professional and personal history will be conducted to generate a Consumer Report (Investigative Background Check) for employment and/or volunteer purposes.  I hereby authorize Edify Administration Professionals, Inc. (d.b.a. Edify Background Screening), an agent of the Organization, to investigate and prepare a Consumer Report (Investigative Background Check) that will include personal information about me.  I understand the report may include, but is not limited to, the following: my creditworthiness or similar characteristics, Employment and education verifications, DMV records and Driving Records, Professional Licensing , Social Media History, Social Security verification, Address History, reference checks, personal interviews, and civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness.  Guardian consent is requested for minors (under age 18 years), and required where local, state, or federal law regulation or ordinance dictate. 

I also agree that a fax, photocopy, or digitally signed version of this authorization with my signature is valid and carries the same authority as the original. 

I hereby authorize and consent to ProfitStaff, LLC’s procurement of such a report.  I understand that I have the right to request, in writing, a complete and accurate disclosure of the nature and scope of this investigation. 

Drug Test Screening Release Form


Important – Please read carefully before signing: 

I understand and agree that:

I hereby CONSENT to allow the agency selected by ProfitStaff, LLC to take a specimen of my hair, urine, or blood and submit it for a pre-employment, random, or reasonable suspicion drug test screen. I FURTHER CONSENT to allow the laboratory testing service to make the results of such screen available to all necessary parties.

In consideration for such services being rendered on my behalf, I hereby RELEASE ProfitStaff, LLC and the laboratory testing service, its officers, agents, and employees, from any and all claims which I might otherwise have due to such results being made so available.   I hereby CONSENT NOT TO FILE ANY ACTION at law or in equity against ProfitStaff, LLC, the laboratory testing service, their respective officers, agents or employees in connection with the results of such screen being made so available, and I hereby agree to INDEMNIFY and HOLD HARMLESS ProfitStaff, LLC, the laboratory testing service, their respective officers, agents, and employees from all damages, expenses, reasonable attorney’s fees, and costs of court which they or any of them may suffer or incur, jointly or severally, due to the results of such screen being made so available.

Disclaimer and E-Signature

If offered temporary employment, all persons, including U.S. citizens, will be required to present original documents verifying identity and employment eligibility in compliance with the Federal Immigration Reform and Control Act of 1986.

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I understand that a routine inquiry or investigation may be made during initial or subsequent processing to provide information applicable to the job for which I am applying. I hereby grant ProfitStaff, LLC permission to access those records that it deems necessary and release all parties from liability. 

I further understand that the position for which I am applying may be a temporary opportunity and if so, I agree that I serve at the will of ProfitStaff, LLC’s client. I agree that, if employed as a temporary employee, ProfitStaff, LLC reserves the right to terminate my employment at any time. I fully understand and agree that if accepted as a temporary employee, I will not be entitled to annual or sick leave, paid holidays, certain health or dental insurance, grievance rights or other benefits normally associated with permanent employment. In consideration of any and all future assignments with ProfitStaff, LLC, I agree to correspond only through ProfitStaff, LLC and not directly with any Clients of ProfitStaff, LLC for such assignments until I have officially accepted an employment agreement with ProfitStaff, LLC’s Client. 

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Signature Certificate
Document name: Application Agreement
Unique Document ID: 2e49f34a3f9ff27d197464e6b5ba849e84d6d631
Timestamp Audit
September 27, 2018 2:08 pm EDTApplication Agreement Uploaded by ProfitStaff LLC - IP
October 24, 2018 8:48 am EDTProfitStaff Applications - added by ProfitStaff LLC - as a CC'd Recipient Ip:
October 24, 2018 4:33 pm EDTProfitStaff Applications - added by ProfitStaff LLC - as a CC'd Recipient Ip:
December 5, 2018 12:53 pm EDTProfitStaff Applications - added by ProfitStaff LLC - as a CC'd Recipient Ip:
February 20, 2019 4:50 pm EDTProfitStaff Applications - added by ProfitStaff LLC - as a CC'd Recipient Ip: