Leading Edge Hospitality

Personal Data - Page 1 of 16

First Name *

Middle Name

Last Name *

Position Applying For *

How did you learn about this position?

Image Photo - Page 2 of 16

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Note: Optional

Contact information - Page 3 of 16

Current Address *

City *

State *

ZIP/Postal Code *

Years at Address *

Home Phone *

Mobile Phone *

Other Phone

E-mail *

I can produce evidence of the right to work while in the U.S.?

I am at least 18 years old?

I am a US Citizen?

Education - Page 4 of 16

GED

High School

College/University

Other, Specify

School Name

School Location

Major/Minor

Degree

Licenses, Certifications (i.e., CPA) (Include agency and/or state/province of issue if applicable)

Employment - Page 5 of 16

ADD EMPLOYMENT

Employer Name	Actions
John Appleseed

Languages - Page 6 of 16

ADD LANGUAGE

Language	Actions
Chinese

Background Information - Page 7 of 16

When completing this section, do not disclose information regarding convictions that have been judicially sealed, expunged, eradicated, impounded, pardoned, dismissed, or nulled. Do not disclose information regarding juvenile court convictions or minor traffic violations. A conviction record does not automatically bar you from employment. All the job-related circumstances surrounding convictions will be considered.

1. In the last 7 years, have you been convicted of, pled guilty or no contest to, been imprisoned, or been on probation or parole for any felony?

Yes

No or No Record

2. In the last 7 years, have you been convicted of, pled guilty or no contest to, been imprisoned, or been on probation or parole for any misdemeanor?

Yes

No or No Record

Business References - Page 8 of 16

ADD BUSINESS REFERENCES

Full Name	Actions
Pizza Hut

Agreement - Page 9 of 16

General Information

I understand making false statements or omitting pertinent facts on this application is sufficient cause for rejection of this application or dismissal from employment. I understand the issuance of this application does not indicate there are any positions open and does not in any way obligate Leading Edge Hospitality to hire me. If hired, I am willing to abide by all present and future rules and regulations of Leading Edge Hospitality. I understand that my employment can be terminated with or without cause and with or without notice at any time at the option of either Leading Edge Hospitality or myself subject to applicable laws. I also understand no Leading Edge Hospitality representative has the authority to guarantee employment for any specified period of time or to make any agreement contrary to the foregoing (with the exception of Leading Edge Hospitality’s Chairman or President, in writing). I declare my answers to the questions on this application are true.

Release of Personal Information

I hereby authorize Leading Edge Hospitality to collect, use, store, transfer, and purge my personal information. I understand that I can request additional information on the purpose, use, and choices related to the personal information that I provide.

Authorization and Release for Reference Checks
and Verification of Information

I authorize Leading Edge Hospitality to conduct work-related reference checks and verify all information using all sources provided on the Employment Application and all related documents (in any form) ("Application") and I release all parties from all liability resulting from the use of information that can be lawfully obtained.

Non-Disclosure and Assignment of
Intellectual Property Rights Agreement

Without Leading Edge Hospitality’s prior written approval, I will not publish, use, copy, retain possession of, or disclose any proprietary or confidential information of Leading Edge Hospitality or any Leading Edge Hospitality Customer. In addition, I understand that the ownership of any work I create will belong to Leading Edge Hospitality, Inc., and I hereby assign any intellectual property rights that arise from my work to Leading Edge Hospitality.

Release for Background Screening

I authorize Leading Edge Hospitality to verify any information that I provide in connection with my employment. I release Leading Edge Hospitality, its customers, its authorized representatives, and the consumer reporting agency from all liability resulting from the use of background information that can be lawfully obtained about me for employment purposes.

Statement of Understanding

I certify that I am at least 18 years of age and that I have completed this form to the best of my ability. I understand that false statements and/or omissions on this application and other applications or hiring-related documents or during the interview, hiring or testing processes may lead to my ineligibility for and/or termination of employment.

I have read this agreement; I understand it, and I agree to its terms.

I agree

Background Screening Notice, Disclosure, And Authorization - Page 10 of 16

Notice and Disclosure

I have been notified that Leading Edge Hospitality may request that a background screening be conducted to verify any information I have provided in connection with my employment with Leading Edge Hospitality or a customer of Leading Edge Hospitality, or to determine my suitability for employment, retention, or reassignment.

Leading Edge Hospitality may request a consumer report and/or an investigative consumer report in connection with my application for employment or at any time during my employment in accordance with all applicable laws. These reports may include information about my background, including but not limited to credit reports, criminal history records, court records, driving records, educational records, and/or employment records.

Upon written request to Leading Edge Hospitality, I have the right to be informed when a consumer report or investigative consumer report is conducted, the nature and scope of the inquiry, and the name and address of the consumer reporting agency2 providing the report.

Authorization

My signature below authorizes the procurement of a consumer report and/or investigative consumer report upon Leading Edge Hospitality’s request in conjunction with my application for employment or during the course of my employment. The results of the reports may be shared among Leading Edge Hospitality, its customer(s), and the reporting agency, when necessary, to determine my suitability for employment, retention, or reassignment.

I acknowledge and authorize.

Background Screening Notice, Disclosure, And Authorization - Page 11 of 16

Full Legal Name *

Social Security No. *

Driver's Licence

State of Issuance

Experiation Date(MM/DD/YYY)

Date of Birth(MM/DD/YYY) *

Certification and Acknowledgement - Page 12 of 16

Certification and Acknowledgement

Certification of Information – I am applying for employment with Leading Edge Hospitality a dba for Progressive Fulfillment LLC. and by signing below declare that the information I have provided in the application process is complete and true to the best of my knowledge. I understand and agree that any false information, omission, or misrepresentation may result in rejection of my application for employment or, if I should be employed by Leading Edge Hospitality, termination from employment. In addition, any such false information, omission, or misrepresentation shall be forwarded to appropriate government agencies and, if after employment, may result in the rejection of any claim for employment benefits including workers' compensation benefits. I attest under penalty of perjury that I am authorized to work in the United States of America. I am aware that if I write false statements or submit false documents for identity and or employment eligibility that I may be fined, imprisoned or both under State or Federal law.

Equal Employment Opportunity – Leading Edge Hospitality is an Equal Employment Opportunity company. All qualified applicants will receive consideration without regard to age, ancestry, color, creed, handicap, marital status, national origin, nationality, or sex. I understand that this form is for use in evaluating my qualifications for employment; it is not an offer, promise, or contract of employment and should not be construed as such in any way.

Verification and Background Investigation - I understand and agree that Leading Edge Hospitality may make or arrange for investigative inquiries in order to determine my suitability for employment or retention and to verify my education, police and driving records, any past or pending civil actions, and credit and workers' compensation history, as allowed by law. I hereby authorize Leading Edge Hospitality and or its agents, including third party investigators and consumer reporting bureaus, to make such inquiries of various public and private agencies or sources, and to request such information and appraisals of my character, job performance and work habits. I acknowledge that a facsimile or copy of this release shall be as valid as the original.

Release of Information - I hereby authorize all former employers, companies, Local, State, Federal and other agencies, courts, and law enforcement authorities to release any information concerning me. I also authorize Leading Edge Hospitality to disclose information on my background and work history (and to provide copies of this Employment Application and Certification and Acknowledgment and any background or reference reports) to representatives of client companies where I may be considered for employment. I hereby release Leading Edge Hospitality and its agents and representatives and any persons, employers, companies, agencies, and authorities who verify or provide information on my background from any liability for any damage whatsoever for disclosing or issuing any such information.

Drug Use and Testing - The use, possession, solicitation for, distribution, purchase, or sale of any illegal substance or alcohol on Leading Edge Hospitality’s or client premises, or while performing any Leading Edge Hospitality job duty is strictly prohibited. I hereby agree to provide a urine, blood, hair, or saliva specimen for drug and/or alcohol testing prior to and or during my employment as a condition of assignment to job positions, or if there is any reason whatsoever to suspect drug or alcohol use. I understand that Leading Edge Hospitality policy requires a drug and alcohol test whenever there is an on-job accident or injury and there is a reasonable possibility that drug use is likely to have contributed to the accident. I hereby authorize and consent to all such tests and acknowledge my understanding that a positive test or refusal to submit to a required test will result in the termination of my employment. I hereby release Leading Edge Hospitality, its agents, representatives, and clients, and any clinic individual, or test product manufacturer that may administer or provide a drug or alcohol test from any and all claims arising out of the result of such a test, and from any action taken on the basis of those results.

If you are injured at work ...

Our Responsibility

The Risk Management staff at Leading Edge Hospitality strives to provide you with the highest standard of services and to ensure that your rights and benefits under law are protected. Our philosophy is to treat you with dignity and respect while managing your work-related claim. Once your injury has been reported to your Leading Edge Hospitality branch location or representative, the staff will work with you to ensure quality medical care.

Your Responsibility

You must immediately report your injury to your work place supervisor and Leading Edge Hospitality branch location or company representative.

You must submit to a mandatory drug and alcohol test for your accident or injuries where there is a reasonable possibility that drug use is likely to have contributed to the accident.

Provide all necessary information to explain the circumstances of your injury, including names of those who may have witnessed your work site accident.

Cooperate with all Leading Edge Hospitality personnel committed to helping you return to work at full capacity. Providing false information or misinformation is illegal and could result in the refusal of your claim and possible criminal charges and/or fines.

• No call no/no show constitutes as a voluntary quit.

When Your Assignment Ends In accordance with Leading Edge Hospitality 's policy and the Department of Labor Multi-State Unemployment Compensation Ruling (subchapter regarding temporary help firms without a written agreement):

UPON COMPLETION OF AN ASSIGNMENT, THE INDIVIDUAL MUST CONTACT THE TEMPORARY HELP FIRM (LEADING EDGE HOSPITALITY) BY THE END OF THE NEXT BUSINESS DAY ("CONTINUING EMPLOYMENT'). FAILURE TO CONTACT OR ACCEPT WORK ON THESE TERMS MAY AFFECT YOUR BENEFIT ELIGIBILITY. FURTHER, REFUSAL OF "SUITABLE WORK' NOT CONSTITUTING "CONTINUING EMPLOYMENT" MAY ALSO AFFECT BENEFIT ELIGIBILITY.

Employment at Will I understand that neither the Employment Application nor this Certification and Acknowledgement represent a contract of employment or a promise of future benefits by Leading Edge Hospitality. I further understand that there is no guarantee that Leading Edge Hospitality will be able to place me with one of its clients. If I am hired by Leading Edge Hospitality, I understand that my status will be that of an employee-at-will, meaning that I will have no contractual right, express or implied, to remain in Leading Edge Hospitality's employ. I further understand that, if I am hired, my employment can be terminated at any time for any reason or for no reason, and with or without notice, at the option of Leading Edge Hospitality or me.

I am voluntarily signing below to acknowledge that I have read and fully understand the Certification and Acknowledgement above. I have had the opportunity to ask questions before signing and all expectations have been presented in a language I understand.

I Agree

I acknowledge and authorize.

Authorization Direct Deposit - Page 13 of 16

I authorize to deposit my pay automatically to the account(s) indicated below and, if necessary, to adjust or reverse a deposit for any payroll entry made to my account in error. This authorization will remain in effect until I cancel it in writing and in such time as to afford a reasonable opportunity to act on it.

I Agree

Name

Last Name

Account Number

Routing Number

Bank Name

Date

Checking

Savings

Upload File - Page 14 of 16

Note: To speed up the hiring process, please fill out and print both I-9 and W-4 forms and bring them with you when you are interviewed. If you are unable to print them, we will provide them during your interview.

I-9 Progressive Form.pdf
W-4 Progressive Form.pdf
Direct Deposit Form.pdf

Upload I-9

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Upload W-4

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Upload Voided Check or bank letter

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Upload others files +

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Password - Page 15 of 16

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Type your account password *

Repeat your account password *

Signature - Page 16 of 16

General information.
Employment application agreement.
Background screening notice, disclosure and authorization.
Certification and Acknowledgement.
Authorization Direct Deposit.

Type your full name

FULL AND PART TIME EMPLOYMENT APPLICATION

General Information

Release of Personal Information

Authorization and Release for Reference Checks and Verification of Information

Non-Disclosure and Assignment of Intellectual Property Rights Agreement

Release for Background Screening

Statement of Understanding

Notice and Disclosure

Authorization

Certification and Acknowledgement

Our Responsibility

Your Responsibility

Authorization and Release for Reference Checks
and Verification of Information

Non-Disclosure and Assignment of
Intellectual Property Rights Agreement