In compliance with the law, Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States. Before employment offer, AFC will verify eligibility to legally work in the United States. Proof will be required in form of documents as required by law to verify your identification and employment authorization. AFC complies with all applicable federal, state and local laws governing non-discrimination in place of employment. AFC is an equal opportunity employer and does not discriminate against based on race, color, religion, sex, national origin, disability,age, or military or veteran status.

BY SIGNING THE APPLICATION: I acknowledge that the purpose of this application is obtaining temporary employment and it does not indicate that any positions are open, nor AFC is obligated to further process my application. By signing the application I certify my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misguiding information in my application or interview can be justification for refusal of employment.I acknowledge that this application is not an employment contract between AFC and me. I understand once hired, my employment will be “at will” and either AFC or I can terminate my employment at any time with or without cause or notice.I hereby authorize the AFC and its appointed agents to contact my references to make any inquiries. If employed I understand I am AFC employee and not of any AFC client. I understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason. I further understand in the event I accept employment with any of AFC client, I need to notify AFC immediately. In such a case the client will be required to pay a fee as agreed between AFC and the client.
(I understand by signing or typing my full names below count as a legal signature).

I agree the Company may rely on this authorization to order background reports, including investigative consumer reports, from companies other than the Background Check Company without asking me for my authorization again as allowed by law. I also agree that a copy of this form is valid like the signed original. I certify that all of the personal information I provided is true and correct.

I do hereby give my consent to authorize my employer known as America’s First Choice Nursing Staffing LLP (AFC Staffing) and the testing laboratory designated to conduct analytical tests deemed necessary, on an ongoing basis, to determine the absence or the presence of Alcohol, Class A Drugs (heroin, cocaine, etc.), Class B Drugs (cannabis,amphetamines, etc.) in my body using urine, hair, blood, breath or any sample as specified by statute and regulation. I give my consent to release the results of the test(s) and other medical information from the laboratory to my employer pursuant to statute or regulation with the condition that the results may not be used in any criminal proceeding. My employer may request proof that I am taking a controlled substance as directed pursuant to a lawful prescription issued in my name. If requested, I agree to provide such proof within 72 hours.I have the right to request a re-test of the initial specimen at a licensed laboratory of my choice if and when I have a positive test for drugs. All requests for a re-test of the sample must be made within ten (10) working days of the receipt of the original positive test result. The results of the samples must be forwarded to me by the appointing authority of the licensed laboratory. I further understand that a positive test, refusal to authorize this form, refusal to take the test, or failure to produce a specimen, may result in disciplinary action up to and including dismissal in accordance with any local, State, or Federal statute, regulation, and policy. Employee’s Signature
[ I understand by signing or typing my full names below count as a legal signature] *