Personal Information Date
Social Security Number Current Address
Phone Referred by Are you 18 years of age or older? * Are you legally authorized to work in the United States? * Have you ever had a professional license revoked, suspended or denied? * If yes, state when, where and why. Have you ever been convicted of, plead guilty or no content to, or received probation, suspension or deferred adjudication for a felony or an offense involving moral turpitude iincluding, but not limited to theft, rape, murder, swindling and indecency with a minor? Employment Desired Position Date you can start
Salary Desired Are you currently employed? If yes, may we inquire with your present employer? Have you ever applied with Comtronix before? If yes, where? When? Education History Name of High School Did you graduate high school? Name of college or university Did you graduate from college? What degree did you obtain and what year did you obtain it? Ex: Bachelors Degree - Business Administration, 2018. Name of trade or speciality school What is your highest level of completed education? General Information What are your work skills that pertain to the job you are applying for? Did you serve in the U.S. Military or Naval Service? If yes, what branch did you serve in? Former Employers
List below your last three employers, starting with your most recent employer.
Job 1 Start Date
Job 1 End Date
Job 1 - Employers Name Job 1 - Salary Job 1 - Position Title Job 1 - Reason for Leaving
Job 2 - Start Date
Job 2 - End Date
Job 2 - Employers Name Job 2 - Salary Job 2 - Position Title Job 2 - Reason for Leaving
Job 3 - Start Date
Job 3 - End Date
Job 3 - Employers Name Job 3 - Salary Job 3 - Position Title Job 3 - Reason for Leaving
Please list the name of three professional references of individuals not related to you, whom you have known at least one year.
Reference 1 - Name
Reference 1 - Phone Reference 1 - Email
Reference 1 - How do you know this person? Reference 1 - Years Known Reference 2 - Name
Reference 2 - Phone Reference 2 - Email
Reference 2 - How do you know this person? Reference 2 - Years Known Reference 3 - Name
Reference 3 - Phone Reference 3 - Email
Reference 3 - How do you know this person? Reference 3 - Years Known Equal Opportunity Employer
It is the policy of the company to abide by all laws pertaining to fair employment practices and the terms and condition of employment at Comtronix are provided without regard to race, color, religion, national origin, sex, age or physical handicap.
Notice of At Will Employment
I understand that, if I am hired by Comtronix (the "Company"), my employment with the Company will be at-will. I understand that my employment can be terminated, with or without cause, and with or without notice, at any time (including before I start working for the Company), at the option of either the Company or myself. I also understand that no term or terms of my employment with the Company are guaranteed, and any term or condition of my employment can be changed by the Company at any time, with or without notice. No promises regarding employment have been made to me and I understand that no promise or agreement regarding employment with the Company is binding upon the Company unless it is made in writing and signed by a Company Corporate Officer. No other employee or manager of the Company has any authority to enter into any agreement for employment or regarding any terms of employment, or to make any other agreement contrary to the foregoing.
"I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application, resume, and/or during any interview, is sufficient cause for refilsal to hire, or dismissal ifI have been employed, no matter when discovered by the Company.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period oftime, or to make any agreement contrary to the foregoing, unless it is in writing and signed by a Company Corporate Officer.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
Please print your name below for authorization.