Streetplus is an equal opportunity employer. The Civil Rights Acts of 1964 and 1991, the Americans with Disabilities Act, and State and Local laws prohibit discrimination on the basis of race, color, religion, sex, national origin, or disability. In addition, the Age Discrimination in Employment Act of 1978 and some State and Local laws prohibit discrimination on the basis of age with respect to individuals who are at least 40 years of age. It is our policy to comply fully with these Acts and information requested on this application will not be used for any purpose prohibited by law.

In consideration of my employment, I agree to follow the rules and regulations as instructed by Streetplus (The Company). I understand that my employment can be terminated with or without cause, and without prior notice at any time by the Company or at my own option. I agree that all information I obtain about the Company, its business and inventions will be maintained in confidence by me and will not be disclosed to third parties. 

I understand that, to the extent allowed by law, information contained in my job application or otherwise disclosed to the Company by me before or during my employment or contract assignment, if any, may be utilized for the purpose of obtaining such consumer reports and/or investigative consumer reports about me. I understand that nothing herein shall be construed as an offer of employment or contract for services.

I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal/state/local), motor vehicle record agencies, my past or present employers, the military, and other individuals or sources to furnish any and all information on me that is requested by the consumer reporting agency.

By my signature (including electronic) below, I certify the information provided on and in connection with this form is true, accurate, and complete. I agree that this form in original, faxed, photocopied or electronic form will be valid for any background reports that may be requested by or on behalf of the Company.

Name *
Name
Date
Date
Mobile Phone
Mobile Phone
Land-line
Land Line Phone
Land Line Phone
Mobile
Do you have a legal right to work in the United States?
Have you ever worked for Streetplus before?
Do you have any relatives employed by Streetplus?
Have you ever been terminated from any position? (A “yes” answer will not automatically disqualify an applicant)
Company Name/Phone/Street/City/State/Zip Code/Job Title/Supervisor/From Date - To Date/Reason for Leaving
Company Name/Phone/Street/City/State/Zip Code/Job Title/Supervisor/From Date - To Date/Reason for Leaving
Company Name/Phone/Street/City/State/Zip Code/Job Title/Supervisor/From Date - To Date/Reason for Leaving
Total Hours Available:
Select Position Applying For
Are you able to perform the job‐related functions of the position for which you are applying, with or without reasonable accommodation?
If “no” please explain: