PERSONAL INFORMATIONFirst Name *Middle NameLast Name *Street Address *Apartment, suite, etcCity *State *ZIP Code *Are you 18 years or older? *YesNoPhone number *Email Address *Position Applying For *Date Available to Start: *Referred byAre you authorized to work in the United States ? *YesNoCan you submit documents or verification of your legal right to work in the United States?YesNoHave you ever been convicted of a crime (other than minor traffic violations)? *YesNoPlease list all convictions, showing offense and date: *Have you ever been terminated from a job or asked to resign? *YesNoIf yes, list dates and explain: *Have you ever worked for the ETI Network before?YesNoIf yes, list dates of employmentDo you have relatives working for the ETI Network?YesNoList namesEDUCATIONSchool or University *Subject studiedDegree *Please selectHigh SchoolGEDTrade, Business, or CorrespondenceAssociatesBachelorsDoctorateMastersOthersGraduated *YesNoGraduatePlease specifyOther subjects of special study or skills:Personal ReferencesPlease list the names of three (3) people who are not related to youName of Person 1 *Phone *Occupation *Years Acquainted *Name of person 2 *Phone *Occupation *Years Acquainted *Name of person 3 *Phone *Occupation *Years Acquainted *Work HistoryBegin with your most recent position including full time, part time or temporary jobs, military service or self employment.Job title *Company *LocationFrom *To *Role description *SupervisorI currently work here *YesNoReason for leaving *Which of these jobs did you like the best?What did you like about this job?Consent *I understand that any untrue or misleading statements in this application can lead to refusal to hire or just cause for discharge.I understand that this application will be considered active for one (1) year. A new application must be completed for further considerationafter one (1) year.I understand that a routine inquiry may be made which will include applicable information concerning character, general reputation, and personal characteristics. I authorize you to verify my past employment and education, criminal records, motor vehicle records, personal references and other job related data provided on this application or via the interview process. Upon written request, additional information as to the nature and scope of the investigation, if one is made, will be provided.I authorize the release of information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties for any damage that may result from furnishing this information to Environmental Technology, Inc.I understand and agree that, if hired, my employment is At-Will and not for a definite period of time and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause.My initialsI have read and fully understand the foregoing statement.Submit applicationSave as Draft
