Employment Application Application for Employment Step 1 of 7 14% Applicant Instructions Thank you for your interest in employment with our Company. We appreciate your application, and look forward to the possibility of you joining our team. This sheet is for your information. Please read it carefully. If you need any assistance or accommodation to facilitate the filling out of this form or during any of the application process, please notify the person who gave you this form and every effort will be made to provide you with the help you request. Please print all information so it can be easily read. Be certain that all questions are completely answered. Incomplete information forms will not be considered. Use the abbreviation "N/A" if a particular provision or section in the form is not applicable to you. If you need additional space, you may use the back of the form. This application form is intended for use in evaluating your qualifications for employment. This is not a contract for employment. False or misleading information given in this form or during the interviewing process are grounds for terminating the application process or, if discovered after employment, for terminating employment. A background check and/or consumer report may be requested by the Company. Employment decisions are made solely on the basis of qualifications to perform the work for which you are applying. Qualifications include education, training, and work experience. Credentials and experience will be verified through schools, former employers, and any other applicable sources. As an Equal Opportunity Employer, we make decisions to hire and promote without regard to race, color, national origin, religion, sex, age, disability or other legally protected status. You should understand that the position for which you are applying is considered at-will, which means that either you or the company can terminate employment for any reason or no reason at any time. No one except the company president has the authority to amend this agreement. We appreciate your interest. Our business is a subscriber to Workers’ Compensation of Texas. Read Instructions Conformation(Required) I have read and understood the above information. Your Personal InformationYour Name(Required) First Middle Last Your Email Address(Required) Enter Email Confirm Email Address(Required) Street Address City State / Province / Region ZIP / Postal Code Phone Number(Required) Are you over 18 years of age?(Required)YesNoHave you ever filed an application with us before?(Required)YesNoAre you currently employed?(Required)YesNoMay we contact your present employer?(Required)YesNoAre you legally authorized to work in the United States?(Required)Proof of identity and work authorization will be required upon employment.YesNo Position You're Applying ForPosition Desired(Required) On what date would you be available for work?(Required) MM slash DD slash YYYY Availability(Required) Full Time Part Time Shift Work Temporary Can you travel if a job requires it?(Required)YesNoDo you have a Transportation Worker Identification Credential (TWIC) Card?(Required)YesNoWhen does your TWIC Expire?(Required) MM slash DD slash YYYY Do you have a valid Basic Plus Card?(Required)YesNoMotor Vehicle History InformationHow many traffic violations have you had during the last two years?(Required) Drivers License Number(Required) Drivers License State(Required) Is your Drivers License Expired, Suspended or Revoked?(Required)YesNo Have you ever been convicted or pled guilty or no contest to a felony offense?(Required)We work in facilities that require background check for employment. For purposes of employment with Aimm Technologies, Inc. and Hydrokinetics, “convictions” include sentenced to confinement, paid fine, time served, placed on probation (including deferred adjudication) and court-ordered restitution. YesNoPlease Explain(Required)*Conviction of a felony will not necessarily bar you from employment.Agree To Felony Conviction Notification(Required)I agree to immediately notify Aimm Technologies, Inc. and Hydrokinetics, if I am convicted of, receive deferred adjudication in, or otherwise plead guilty or no contest to a felony, or any crime involving dishonesty or a breach of trust, while my application is pending or during my period of employment, if hired. I agree to the above statement. Education DetailsHighest level of education completed(Required)High School/GEDSome CollegeAssociates DegreeBachelors DegreeOtherName, address, city and state of last school attended:(Required) Vocational or Business schools attended:Enter none if not applicable. Previous EmploymentYour Previous EmployersPlease list your previous employers, the dates you worked and the position you held. Click the plus sign to add additional employers as necessary. You can use this form to add up to three employers.EmployerDatesPositionReason for leaving Add RemoveRefrencesName only those persons who are familiar with your work capabilities. Do not list relatives. Use the plus sign on the right to add additional rows.NamePhonePositionEmailCompany/Relationship Add Remove Upload Your ResumeIf you have one available please upload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.Terms and Conditions(Required)I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are accepted at that time. I understand that I may be required to successfully complete a pre-employment physical examination conducted by a company-authorized physician and that I may be required to successfully complete a pre-employment drug/alcohol screening after a job offer of employment has been made. I agree to the terms and conditions.Voluntary InformationThe Equal Employment Opportunity Commission (EEOC) requires organizations with 100 or more employees to invite applicants to self-identify gender and race in order for the company to complete an EEO-1 report each year. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. Responses will remain confidential within the Human Resources Department and will only be used for reporting requirements to the government. When reported, data will not identify any specific individuals. This information is kept separate from your application.GenderMaleFemaleRace/EthnicityChoose one corresponding to the ethnic group to which you identify):Hispanic or LatinoWhiteBlack or African AmericanAsianNative Hawaiian or Other Pacific IslanderAmerican Indian or Alaska NativeTwo or more races
