Fill and Sign the Contract Agency Form

Contract between Employment Agency and Applicant (including a Release from Applicant in favor of Employment Agency) (Name of Employment Agency) (Address of Employment Agency) Listing No.: _______________________ Date of Listing: ______________________ For and in consideration the sum of One Dollar and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, ___________________________ , a (name of state) corporation, ______________ and _______________________ (street address, city, county, state, zip code) , referred to herein as (“Applicant”) hereby agree as follows: 1. ________________ shall furnish correct information (supplied by Applicant) by which Applicant shall be enabled to secure employment as a _____________________ (type of position sought) in the _______________________________ (geographical area). 2. __________________ will not charge any fee to the Applicants. Any fee charged will be paid by the employer who employs Applicant as a result of ______________ submitting the resume of Applicant and application form to the prospective employers. Said employers will handle any interview and /or screening of Applicant. 3. ________________ will have no part in the decision of whether or not an employer hires Applicant. Said decision shall be the sole responsibility of the employer. ______________ will merely act as a provider of information to prospective employer, which information shall be provided to ________________ by Applicant. 4. For the same consideration as aforesaid, Applicant, for himself, his spouse, legal representatives, heirs and assigns, hereinafter jointly and severely referred to as Releasor, hereby releases, waives and discharges _____________, its employees, officers, agents, owners and/or assigns and each of them, hereinafter jointly and severely referred to as Releasee, from all liability to the Releasor for any and all loss or damage, and any claim or damages resulting therefrom, resulting from the services of ____________ to Applicant as described above, whether caused by the negligence of Releasees or otherwise. Releasor also agrees to indemnify the Releasees and hold them harmless from any loss, liability, damage or cost they may incur, whether caused by the negligence of the Releasees or otherwise. WITNESS our signatures as of the day and date first above stated. NAME OF EMPLOYMENT AGENCY ________________________ By_______________________ JOHN DOE (Name and Office in Corporation)