Employment Application


It is the policy of the Commonwealth of Massachusetts to afford equal employment opportunity to all qualified persons regardless of race, color, religious creed, national origin, age, military status, sexual orientation, disability, genetic information, gender identity, gender expression or gender unless based upon a bona fide occupational qualification.

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  • Employment Desired

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THIS IS AN INSERT provided for Informational Purposes Only

In compliance with the Immigration and Reform and Control Act of 1986, you will be required to provide approved documentation that verifies your right to work in the United States prior to beginning work. Please be prepared to provide any of the following documentation if you are offered and accept a position. This Verification Process Is Required For All Employees (Both Citizen And Non-Citizen) Hired After November 6, 1986. The list below is effective March 2013.

List A: Any one of the following: (These establish both identity and employment authorization)

  1. U.S. Passport or U.S. Passport Card
  2. Permanent Resident Card or Alien Registration Receipt Card (Form I-551)
  3. Foreign passport that contains a temporary I-551 stamp or temporary I-551 printed notation on a machine-readable immigrant visa.
  4. Employment Authorization Document containing a photo (Form I-766)
  5. For a non-immigrant alien authorized to work for a specific employer because of his or her status: a foreign passport with Form I-94 or Form I-94A bearing the same name as the passport and containing an endorsement of the alien’s nonimmigrant status as long as the period of endorsement has not yet expired and the proposed employment is not in conflict with any restrictions or limitations identified on the form.
  6. Passport from the Federated States of Micronesia (FSM) or the Republic of the Marshall Islands (RMI) with Form I-94 or Form I-94A indicating non-immigrant admission under the Compact of Free Association between the United States and the FSM or RMI.

OR one from List B and one from List C:

LIST B These establish identity:

  1. State Driver’s license or similar state I.D. card with photo or other approved identifying information such as name, date of birth, gender, height, eye color, and address
  2. ID card issued by federal, state, or local government agency containing photo or identifying information such as name, date of birth, gender, height, eye color, and address
  3. School ID card with photograph
  4. Voter’s registration card
  5. U.S. Military card or a draft card
  6. Military dependent’s ID card
  7. U.S. Coast Guard Merchant Mariner Card
  8. Native American tribal document
  9. Driver’s license issued by a Canadian government authority

For those under 18 years of age who are unable to present a document listed above:

  1. School record or report card
  2. Clinic, doctor, or hospital record
  3. Day-care or nursery school record

LIST C These establish employment authorization:

  1. Social Security Account Number card unless the card includes one of the following restrictions: not valid for employment, valid for work only with INS Authorization, or valid for work only with DHS authorization
  2. Certification of Birth Abroad issued by the U.S. Department of State (Form FS-545)
  3. Certification of Report of Birth issued by the U.S. Department of State (Form DS-1350)
  4. Original or certified copy of a birth certificate bearing an official seal issued by a state, county, municipal authority, or outlying possession of the United States
  5. Native American tribal document
  6. U.S. Citizen ID Card (Form I-197)
  7. ID Card for Use of Resident Citizen in the United States (Form I-179)
  8. Employment authorization document issued by U.S. Department of Homeland Security

Optimum Labs Inc.
413 County St. New Bedford, MA 02740
Office: (508) 993-3710
Fax: (508) 993-3814
Email: info@optimumlabsinc.com