For all New Hires, please complete and submit this form.
All New Hire Employees must be compliant with all required Onboarding Forms prior to the start of any staffing. This form is to accompany all completed New Hire Packets or the USA Onboarding Portal. Please complete this form with as much information as possible regarding the new Assignment. Client Legal Entity Name* Do you have any employees currently working at this customer?* Yes No Client Supervisor Contact Information*NameTitlePhone NumberEmail Accounts Payable Contact Information*NameTitlePhone NumberEmail Job Assignment(s) DetailsPlease list employees below that are expected to work at the listed worksite. If there is a separate worksite address, a new form will need to be completed.Worksite Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Is this a new worksite address?* No, we have active employees here Yes Has this worksite been approved by USA Staffing Services?* Yes No, this is a first time placement at this worksite Which USA representative approved the worksite?* Do you need to add a new time approver for this worksite?* Yes No Time Approver Contact Info For The Listed WorksiteNameTitlePhone NumberEmailDepartment (If Known) Employee(s) Information*Please fill out entire row for each employee who is startingNameEmailPhoneJob TitlePay RateBill RateStart DateTime Approver Full Name Pre-employment Screening RequirementsWhat criminal screening Tests are required by this client?* National Criminal Database Search Statewide Criminal History County Criminal History SSN authentication Sex Offender (nationwide) Motor Vehicle Report Other screening tests not listed What other screening tests are required?*Which pre-employment drug screen or OHS screenings are requested?* No drug screen or OHS screening are required by client 10-Panel Drug Screen (Instant) 10-Panel Drug Screen (Lab draw) 5-Panel Drug Screen (Instant) 5-Panel Drug Screen (Lab draw) Lift Test Blood Alcohol Test Audiogram Other(s) not listed Additional screening chargesSelecting this screening requests may be subject to additional costs for onboarding.Other pre-employment screenings or OHS screenings*UploadsAdditional Supporting Document(s)If you have any other documents you wish to share, you can upload them here. Multiple files can be uploaded. Drop files here or Select files Max. file size: 256 MB. Completed By* First Last Please enter your email to receive a copy of this submission. If multiple emails, please use a semicolon to separate the email addresses*
