Foshee Online Form

Foshee Job Application Form

Step 1 of 11

THE FOSHEE COMPANIES

Application for Employment

Thank you for considering Foshee Payroll in your job search. Foshee Payroll is an equal employment opportunity employer and does not discriminate on the basis of sex, age, race, color, religion, national origin, mental or physical disability, marital status or military service or (any state protected classifications). No application will be rejected as a result of a disability that, with reasonable accommodation, does not prevent performance of the essential job duties.

CONFIDENTIAL

Please complete by printing in dark ink, complete all questions and sign your initials and name on the last page where indicated.

Date

MM slash DD slash YYYY

PERSONAL INFORMATION

First Name

Middle Name

Last Name

Street Address

City and State

Zip Code

Cell Phone Number

Work Phone Number

E-Mail Address

Which position are you applying for?

Salary Desired

Date You Can Begin

MM slash DD slash YYYY

EDUCATION

High School

City and State

Last Year Completed

9th

10th

11th

12th

Did You Graduate?

YES

College or University

City and State

Last Year Completed

Please enter a number from 1900 to 2050.

Degree

Other Schools

City and State

Last Year Completed

Please enter a number from 1900 to 2050.

Certificate or License

SPECIAL SKILLS

Software Applications

Other Skills

EMPLOYMENT RECORD

Please list your most recent jobs first. Include military service as part of your employment record. If you have a resume, please attach it with this form.

Employer

Address

Telephone Number

Supervisor's Name

Job Title

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

Essential Job Duties

Employer

Address

Telephone Number

Supervisor's Name

Job Title

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

Essential Job Duties

Employer

Address

Telephone Number

Supervisors

Job Title

Start Date

MM slash DD slash YYYY

End Date

MM slash DD slash YYYY

Starting Salary

Ending Salary

Reason for Leaving

Essential Job Duties

Professional References

Please list three professional references that can be contacted.

Name

Job Title / Company

Telephone Number

Email Address

Name

Job Title / Company

Telephone Number

Email Address

Name

Job Title / Company

Telephone Number

Email Address

GENERAL INFORMATION

May we contact your present employer?

Yes

Do you have the legal right to work in the United States? (if hired, you will be required to provide identification to prove eligibility for employment)

Yes

Have you been employed or attended school using any other name? If yes, please indicate names previously used.

Yes

Previously Used Name(s)

Have you ever been convicted, pled guilty or no contest, or forfeited bond or bail for any crime other than traffic violations?

Yes

If yes, please explain:

(Conviction of a crime is not an automatic bar to employment. Factors such as the nature and gravity of the crime, the length of time that has passed since the conviction and/or completion of any sentence, and the nature of the job for which you have applied will be considered.)

Are you able to perform the primary duties of the job as outlined in the newspaper advertisement, announcement, posting, job line, job description, with or without reasonable accommodation?

Yes

If no, please explain:

Do you have any employment restrictions resulting from a non-compete or confidentiality agreement?

Yes

If yes, please explain:

WHY ARE YOU INTERESTED IN JOINING OUR TEAM?

Please write three to five sentences explaining why you are seeking employment with us.

This field is hidden when viewing the form

DID A CURRENT/FORMER FOSHEE EMPLOYEE REFER YOU TO US? IF SO, LIST THEM BELOW:

Please write three to five sentences explaining why you are seeking employment with us.

ADDITIONAL INFORMATION:

Please use the space provided to list any additional employers, periods of time not worked, or any other information that you believe we should know in considering your application for employment.

Please read carefully, initial each paragraph and sign below:

I certify that I have answered the above questions truthfully and have not withheld any information relative to my application. I understand that any falsification, misrepresentation, or omission, as well as any misleading statements or omissions of the application information, attachments, and supporting documents generally will result in denial of employment or immediate termination, if discovered after hire.

I authorize Foshee Payroll to thoroughly investigate my references, work record, education and other matters related to my suitability for employment, and further authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I release Foshee Payroll, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I authorize Foshee Payroll to investigate whether I have a criminal record of convictions, and, if so, the nature of such convictions and all the surrounding circumstances of the conviction. Foshee Payroll has advised me that any criminal background check will focus on convictions, and that a criminal record will not necessarily disqualify me from employment.

If hired, I recognize the rules and policies of Foshee Payroll I understand that my employment and compensation can be terminated at any time, with or without cause, and with or without notice, at the option of Foshee Payroll or myself. I understand that the Owner of the company is the only person who will ever have the authority to create any other terms of employment and/or to enter into any employment contract and that all such contracts must be in writing and signed by both parties. However, I also understand that unless otherwise stated in an employment contract, the company may change, withdraw and interpret other policies (including wages, hours and working conditions) as it deems appropriate.

I understand and acknowledge that I may be required to submit to a physical examination, including drug test. Additionally, I hereby authorize the release of the results of such an examination to Foshee Payroll for their use in evaluating my suitability for employment. Further, I release the examining facility and Foshee Payroll from any and all liability, and from any damage that may result from the release of such information.

Signature

Date

MM slash DD slash YYYY

Important Information To Know Before Completing An Application for Employment With Foshee Payroll

All areas of the application must be filled out completely and accurately. Please fill in the required information directly on the application and do not indicate “see resume”.
If you are offered a position with Foshee Payroll, be aware that we may verify all of the information that you have written on the application, as well as your resume. If there is a discrepancy in your information, the job offer may be withdrawn. It is important to be sure that what you have written is correct.
If you have any questions about completing the application, it is important to please ask the Foshee Payroll representative who has been assisting you.
Your information will be processed using E-Verify.

Applicant Acknowledgement

My signature below indicates that I have read and understand the importance of supplying accurate information on the application. I am also aware of the possibility of an offer of employment being withdrawn if any of the information is not correct.

Signature of Applicant

Date

MM slash DD slash YYYY

DISCLOSURE OF PROCUREMENT OF CONSUMER REPORT

PLEASE BE ADVISED that Foshee Payroll, LLC (the “Company”) may obtain information about you from a third-party consumer reporting agency to evaluate your eligibility for employment purposes. Thus, you may be the subject of a consumer report which may include information about your character, general reputation, personal characteristics, or mode of living.

DISCLOSURE OF PROCUREMENT OF INVESTIGATIVE CONSUMER REPORT

PLEASE BE ADVISED that Foshee Payroll, LLC (the “Company”) may obtain an investigative consumer report about you from a third-party consumer reporting agency for employment purposes. This report may include information about your character, general reputation, personal characteristics, and mode of living, and it may involve personal interviews with sources such as your neighbors, friends, and associates, as well as past and present employers, coworkers, references or others. You have the right, upon written request to the Company made within a reasonable period of time after receipt of this notice, to request a complete and accurate disclosure of the nature and scope of the investigation requested by the Company. You also have the right to request a summary of your rights under the federal Fair Credit Reporting Act.

AUTHORIZATION

I HEREBY AUTHORIZE Foshee Payroll, LLC (“the Company”) to obtain consumer reports and investigative consumer reports about me at any time after receipt of this Authorization and, if I am hired, throughout my employment. To this end, I hereby authorize, without reservation, any person or entity, law enforcement agency, administrator, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information to Global HR Research, LLC (“GHRR”) at 9530 Marketplace Road, Suite 301, Fort Myers, FL 33912, www.ghrr.com.

The term background information includes, but is not limited to, employment history, reference checks, criminal and civil history information, motor vehicle records, moving violation reports, sex offender status information, credit reports, education verification, professional licensure verification, drug testing, and information related to my Social Security Number.

I acknowledge receipt of three separate documents entitled Disclosure of Procurement of Consumer Report, Disclosure of Procurement of Investigative Consumer Report, and a Summary of Your Rights under the Fair Credit Reporting Act, and I certify that I have read and understood all of those documents. I understand I can view GHRR’s Privacy Policy on its website at www.ghrr.com. I agree that a facsimile, electronic or photographic copy of this Authorization shall be as valid as the original.

Signature of Applicant

Print Name of Applicant/Employee

Date

MM slash DD slash YYYY

CONSUMER INFORMATION SHEET

NOTE TO CLIENT: This is needed for manual orders only. Clients using our electronic consent process do not need to use this page. Clients using our screening platform to place orders do not this page.

NOTE TO CONSUMER: The following is used only for the purpose of performing a background check. To view GHRR’s privacy policy, please go to www.ghrr.com/privacy-policy/.

Name

First Name Middle Name Last Name

Date of Birth

MM slash DD slash YYYY

Social Security Number

Driver's License Number

Current Address

City

State

Zip Code

Previous Address (Past 7 Years)

City

State

Zip Code

Previous Address (Past 7 Years)

City

State

Zip Code

Previous Address (Past 7 Years)

City

State

Zip Code

Degree Obtained

Graduation Date

MM slash DD slash YYYY

Name of School

City & State of School

Name Used at Time of Graduation

Other Aliases (Other Names I Have Been Known By)

Phone

Para información en español, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.

You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.
You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
- a person has taken adverse action against you because of information in your credit report;
- you are the victim of identity theft and place a fraud alert in your file;
- your file contains inaccurate information as a result of fraud;
- you are on public assistance;
- you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete, or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
You may limit “prescreened” offers of credit and insurance you get based on information in your credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-OPTOUT (1-888-567-8688).
The following FCRA right applies with respect to nationwide consumer reporting agencies:

CONSUMERS HAVE THE RIGHT TO OBTAIN A SECURITY FREEZE
You have a right to place a “security freeze” on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit.

As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer’s credit file. Upon seeing a fraud alert display on a consumer’s credit file, a business is required to take steps to verify the consumer’s identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.

A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements.
You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

TYPE OF BUSINESS:	CONTACT:
1.a. Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates b. Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the CFPB:	a. Consumer Financial Protection Bureau 1700 G Street, N.W. Washington, DC 20552 b. Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580 (877) 382-4357
2. To the extent not included in item 1 above: a. National banks, federal savings associations, and federal branches and federal agencies of foreign banks b. State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and Insured State Branches of Foreign Banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act c. Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations d. Federal Credit Unions	a. Office of the Comptroller of the Currency Custom Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050 b. Federal Reserve Consumer Help Center P.O. Box. 1200 Minneapolis, MN 55480 c. FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106 d. National Credit Union Administration Office of Consumer Financial Protection (OCFP) Division of Consumer Compliance Policy and Outreach 1775 Duke Street Alexandria, VA 22314
3. Air carriers	Asst. General Counsel for Aviation Enforcement & Proceedings Aviation Consumer Protection Division Department of Transportation 1200 New Jersey Avenue, S.E. Washington, DC 20590
4. Creditors Subject to the Surface Transportation Board	Office of Proceedings, Surface Transportation Board Department of Transportation 395 E Street, S.W. Washington, DC 20423
5. Creditors Subject to the Packers and Stockyards Act, 1921	Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies	Associate Deputy Administrator for Capital Access United States Small Business Administration 409 Third Street, S.W., Suite 8200 Washington, DC 20416
7. Brokers and Dealers	Securities and Exchange Commission 100 F Street, N.E. Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations	Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Listed Above	Federal Trade Commission Consumer Response Center 600 Pennsylvania Avenue, N.W. Washington, DC 20580 (877) 382-4357