Type of Degree

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If YES, what are they?

Staff Station’s COMMITMENT

PLACEMENT. Staff Station, LLC, will attempt to secure placement of the Applicant on a per diem basis at an assignment with a facility. This time period may be extended at the completion of the assignment as long as the facility, applicant, and Staff Station, LLC, agree on the terms agreed to at the time of the extension.

PAY RATE. Staff Station, LLC, agrees to pay the applicant according to the pay rate indicated on the Employee Rate Sheet, and in accordance with applicable Federal, State, and Local laws. The pay rate may vary according to location of assignment and may change if there is an extension of the current assignment or relocation to a new assignment. Any pay rate changes will be addressed with an updated Employee Rate Sheet, which is provided to the applicant for acceptance. Rejection of the Employee Rate Sheet constitutes immediate termination of any arrangement between Staff Station, LLC, and the Applicant.

24/7. Staff Station, LLC's phone lines are open twenty-four (24) hours per day, seven (7) days a week for the Applicants convenience. Staff Station, LLC, reserves the right to change hours of operation at anytime with or without notification.

DISCLAIMER. Staff Station, LLC, reserves the right, and the Applicant acknowledges that Staff Station, LLC, may at anytime and for any reason, change any rules, regulation, and/or policies, with or without notice.

APPLICANT’S COMMITMENT

EDUCATION AND TRAINING. Applicant states that he/she has obtained education and training in the healthcare field and is duly licensed and authorized to practice nursing.

PLACEMENT ACCEPTANCE. Once Corporation secures placement for Applicant at an assignment, Applicant agrees that his or her acceptance, will be binding. All placement details specific to assignments will be derived from the parameters outlined in the Nurse Profile that Applicant completes upon hire. Applicant is obligated to accept placement position secured by Corporation as outlined in the Nurse Profile. It is the responsibility of the Nurse to update his/her profile so that is it current at all times.

EMPLOYEE AT WILL. Applicant acknowledges that Staff Station, LLC, employs Applicant “at will” and that no employment promises have been made for any duration of time. Specifically, Applicant understands that Applicant may quit employment at any time with Staff Station, LLC, with or without notice. Similarly, Applicant understands that Staff Station, LLC, may discharge Applicant at any time, without notice, for any lawful reason or no reason. Contracts of employment can only be made by a written agreement between Applicant and Staff Station, LLC, and require the approval and signature of the President and Chief Executive Officer of Staff Station, LLC, or authorized representative. Further, for whatever reason, should Facility decide to end Applicant’s assignment prior to completion date, Staff Station, LLC, may propose a new assignment as long as Applicant is in good standing with Staff Station, LLC,

NON-DISCLOSURE AND LIMITED NON-COMPETE. Applicant agrees not to disclose any of Staff Station, LLC, trade secrets or any confidential or proprietary information of Staff Station, LLC, Staff Station, LLC, employees, Facilities, or of patients of Facilities. Applicant further agrees not to compete either as a direct competitor or with a competing company at the Facility assignment where Applicant has been placed by Staff Station, LLC, for a term of three (3) months after Applicant’s final day of work at Facility.

NON-SOLICITATION OF CORPORATION EMPLOYEES. Applicant agrees not to solicit Staff Station, LLC, employees to work for any competing company while on assignment with a Staff Station, LLC, facility, and for a period of three (3) months thereafter.

DRUG SCREENS. Prior to placement and throughout employment with Staff Station, Applicant consents to a urine, blood or breath sample for the purposes of an alcohol, drug, intoxicant, or substance abuse screening test. Applicant also gives permission for the release of the test results determining the fitness of employment or continued employment. Applicant will utilize clinics that are approved by Staff Station, LLC,

BACKGROUND CHECKS. Before the Applicant is placed and throughout employment with Staff Station, Staff Station, LLC, may, upon a facility’s request, conduct background checks of any kind from any location for any purpose Staff Station, LLC, considers reasonable. Applicant also gives permission for the release of the results for determining the fitness of employment or continued employment.

EMPLOYMENT AND MEDICAL INFORMATION RELEASE. I authorize Staff Station, LLC, to release any and all confidential employment and medical information contained in my employment file to any medical facility or entity with whom Staff Station, LLC, has a staffing agreement, and to any other governmental or regulatory agency at such agency’s request. For all other purposes, Staff Station, LLC, shall keep my employment and medical records confidential and shall advise any medical facility or other entity to which records have been provided to also keep such records confidential. I hereby hold Staff Station, LLC, harmless for any result(s) that arise with regards to the release of this confidential information by Staff Station, LLC,

RECORDING OF TIME WORKED. Applicant agrees to abide by Staff Station, LLC, procedures for reporting of time worked including hospital supervisor approval for shift time worked and missed lunch periods. The Staff Station, LLC, workweek begins 7 AM Sunday and concludes at 6:59 AM Sunday. Applicant’s reporting of time worked must reach Staff Station, LLC, each week by 12 PM Central Time each Monday to be paid in the current week. Any late submissions may be paid the following week.

LUNCH BREAK POLICY. Applicant will clock in and out for a period of no less than thirty (30) minutes and no longer than one (1) hour or per facility policy for meal periods. If the Facility requests the Applicant to work their lunch period due to patient care and safety, the Applicant agrees to obtain approval by Facility Nurse Manager as required by Staff Station, LLC, for each applicable shift.

TERMINATION. Applicant understands that if he/she leaves his/her assignment early for any reason or is terminated by Staff Station, LLC., Applicant is expected to vacate company premises and is expected to vacate company provided housing within 24 hours, and will be responsible for the return of all costs incurred by Staff Station, LLC, for such termination. Applicant authorizes Staff Station, LLC, to deduct any incurred costs from their paycheck.

GENERAL

CHOICE OF LAW. This agreement will be construed in all respects according to the laws of the state of Tennessee.

CONFIDENTIALITY OF AGREEMENT. Staff Station, LLC, and Applicant will maintain the confidentiality and exclusivity of this Agreement.

AGREEMENT REVIEW. Staff Station, and Applicant agree that each party has fully read and reviewed this Agreement and should any ambiguities arise, the interpretation of the ambiguity will not automatically be that of the Applicant.

EQUAL OPPORTUNITY EMPLOYER. Staff Station, LLC, is an equal opportunity employer. Staff Station, LLC, does not discriminate in respect to hiring, firing, compensation, and all other terms and conditions of privileges of employment on the basis of race, color, national origin, sex, age or related medical conditions, or disability.

NOTICES. Any notices, which are required or permitted will be in writing and will be, deemed properly delivered to the other party when sent U.S. Mail, certified, postage prepaid and addressed to the following:

Applicant understands that this is not a complete listing of Policies and Procedures of Staff Station, LLC, Complete details are included in the Staff Station, LLC, Policy and Procedures manual that will be given to the applicant upon hire.

• I will not discuss any elements of my compensation with anyone employed at the host facility.
• I will not discuss any previous assignment worked for Staff Station, LLC, with anyone employed at the host facility.
• I will not recruit any nurses at the host facility, whether temporary or permanent employees.
• I will communicate with the management, staff and patients of the host facility in a respectful manner at all times.
• I will honor all terms of the primary applicant agreement.
• I will honor the policies and procedures of Staff Station, LLC, and the host facility.

I certify that I have read, understand and intend to comply with the Primary Applicant Agreement and Professional Conduct Expectations and that the facts contained in this application are true and accurate. I understand that any misrepresentation or omission of facts is cause for dismissal. I authorize the employer to investigate any and all statements contained herein and request the persons, firms, and/or corporations named above to answer any and all questions relating to this application. I release all parties from liability, including but not limited to, the employer and any person, firm or corporation who provides information concerning my prior education, employment or character.