Fill and Sign the Employment Application Imperial Health Form

Contract between Employment Agency and Applicant ________________________________ ________________________________ ________________________________ ________________________________ (Name and 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, _____________ Employment Agency, Inc., a _______________________ (name of state) corporation, (“Agency”) and _____________________________ (name of applicant) __________________________________________________________ (street address, city, county, state, zip code) , referred to herein as (“Applicant”) hereby agree as follows: 1. Agency 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. Agency will not charge any fee to the Applicants. Any fee charged will be paid by the employer who employs Applicant as a result of Agency’s submitting the resume of Applicant and application form to the prospective employers. Said employers will handle any interview and /or screening of Applicant. 3.Agency 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. Agency will merely act as a provider of information to prospective employer, which information shall be provided to Agency by Applicant. WITNESS our signatures as of the day and date first above stated. _____________ EMPLOYMENT AGENCY, INC. ________________________ By_______________________ Applicant (Name and Office in Corporation)