Qualified applicants
receive equal consideration. No question is asked for the purpose of
excluding any applicant due to race, creed, color, national origin,
religion, age, sex, handicap, veteran status, marital status, sexual
orientation, or any other characteristic protected by law. We are equal
an opportunity employer.
You must fill out form in it's entirety.
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| First Name: |
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Last Name: |
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| Address: |
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| City: |
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State: |
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| Zip: |
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Phone: |
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| E-mail: |
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| Desired Position: |
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| If Other: |
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Employment History
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list chronologically, beginning with most recent experience. |
| Employer: |
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Address/City: |
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| From (MM/YYYY): |
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To (MM/YYYY): |
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| Supervisor: |
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Phone: |
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| Salary: |
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| Type of Work: |
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| Reason for Leaving: |
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| Employer: |
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Address/City: |
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| From (MM/YYYY): |
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To (MM/YYYY): |
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| Supervisor: |
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Phone: |
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| Salary: |
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| Type of Work: |
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| Reason for Leaving: |
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| Employer: |
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Address/City: |
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| From (MM/YYYY): |
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To (MM/YYYY): |
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| Supervisor: |
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Phone: |
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| Salary: |
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| Type of Work: |
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| Reason for Leaving: |
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Education
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Personal Information
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| Member
of the Drug-Free Workplace Network. Pre-Employment Drug Testing is a
Requirement. |
Are you legally authorized to work in the
U.S.?:
(If hired, you
will be required to provide proof of work authorization.) |
Yes No |
| Are you at least 18 years of age?: |
Yes No |
| Please state your date of
birth, and briefly describe skills
you may have that you acquired in other employment or armed forces:
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| Have you ever been convicted of a crime
(felony)?: |
Yes No |
If yes, give details:
(Convictions
are not automatic bar to employment) |
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| If you are experienced
operator of any office machines or equipment, please list: |
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| Typing speed?: |
wpm |
Shorthand?: |
wpm |
| If you are experienced
operator of any plant machines or equipment, please list: |
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| Do you have any other
skills you wish to mention?: |
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| Are you presently employed?: |
Yes No |
| If so, may we contact your present employer?:
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Yes No |
| If hired, when would you be available?: |
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Employment References
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| List
individuals familiar with your job qualifications (No relatives or
personal friends). |
| 1) Name of Reference: |
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2) Name of Reference: |
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| Occupation: |
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Occupation: |
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| Address: |
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Address: |
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| City/State/Zip: |
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City/State/Zip: |
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| Phone: |
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Phone: |
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| Relationship: |
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Relationship: |
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| How long known: |
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How long known: |
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Invitation to Identify for Affirmative Action
Purposes
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HiTech Integrated Solutions, is committed to the
employment and advancement of minorities, females, and individuals with
disabilities and veterans. If you fall into one of these protected
classifications, we invite you to identify yourself and receive
coverage under our company's Affirmative Action Plan.
You may inform us of your desire to benefit under the program at this
time and/or any time in the future.
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| Gender: |
Male |
Female |
| Indicate The Appropriate Race/Ethnic Group:
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| How Were You Referred To This Job: |
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Please read carefully before
submitting your application All information contained in this
application is true and correct to the best of my knowledge and belief.
I understand that misrepresentations or omissions of any kind may
result in denial of employment or be cause for subsequent dismissal if
I am hired. I authorize the company to investigate my responses on this
application and contact any or all of my former employers or any
individuals familiar with me or my employment background for the
purpose of verifying any information, I have provided and/or for the
purpose of obtaining any information, whether favorable or unfavorable,
about me or my employment. I voluntarily and knowingly fully release
and hold harmless any person or organization that provides information
pertaining to me or my employment. I understand that upon receiving a
job offer, a physical examination and drug screening may be required.
(Note: If this is a job requirement, you will be notified.)
Regardless of whether or not I become employed by the company, I
recognize that this application is not and should not be considered a
contract of employment. I understand that employment at the company is
on an at-will basis and that my employment may be terminated with or
without cause, and without notice, at any time, at my option or the
company's unless specifically provided otherwise in a written
employment contract. I further understand that no company employee or
representative has the authority to enter into a contract regarding
duration or terms and conditions of employment other that an officer or
official of the company, and then only by means of a signed written
document. We have a policy of no smoking on the premises.
Check this box to certify that you have read
and accept the above statement.
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