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Employment Application

ITC is an equal opportunity employer and will not discriminate against any applicant on the basis of any characteristic that is protected by State and Federal law.

* Required Field

Position Applying for*

Date of Application*

Date you can start*

Full Name*

Present Address*

Permanent Address

Preferred Phone*:
Alternate Phone:

Email*:


Are you 18 years old, or older?
 Yes No

Are there any hours or days of the week that you cannot work?
 Yes No

If yes, when?

Desired Salary:

Employment Type:
 Full Part

Are you currently employed?
 Yes No

Name, job title & phone number of current employer:

Have you previously applied for work at ITC Incorporated?
 Yes No

If yes, in what position, and under what name?

 


EDUCATION:

High School
Name & Location of School

Number of Years Attended
Did You Graduate?  Yes No
Subject/Major

College
Name & Location of School

Number of Years Attended
Did You Graduate?  Yes No
Subject/Major

Trade School/SpecializedTraining
Name & Location of School

Number of Years Attended
Did You Graduate?  Yes No
Subject/Major
 


Did you serve in the Military?
 Yes No

If yes, Date Entered:

Branch:

Rank:

Date of Discharge:

Honorably?
 Yes No


Are you legally entitled to be employed in the United States?
 Yes No

Have you ever been convicted of a crime except a minor traffic violation?
 Yes No

If so, please state citation, date and location of the offense:

Please provide any additional information such as special skills, training, management
experience, equipment operation or special qualifications:
 


CURRENT AND FORMER EMPLOYERS:

Employer 1
Dates of Employment
Employer Name, Address, and Telephone

Salary
Last Position Held / Responsibilities

Reason For Leaving
 

Employer 2
Dates of Employment
Employer Name, Address, and Telephone

Salary
Last Position Held / Responsibilities

Reason For Leaving
 

Employer 3
Dates of Employment
Employer Name, Address, and Telephone

Salary
Last Position Held / Responsibilities

Reason For Leaving

Employer 4
Dates of Employment
Employer Name, Address, and Telephone

Salary
Last Position Held / Responsibilities

Reason For Leaving
 

May we contact your current employer(s)?
 Yes No

If no, please advise which we may not contact:
 


References

Reference 1
Name

Address & Telephone

Relationship
Years Acquainted
 

Reference 2
Name

Address & Telephone

Relationship
Years Acquainted
 

Reference 3
Name

Address & Telephone

Relationship
Years Acquainted
 


Please read the following statement carefully before submitting to indicate your understanding.

I understand that, prior to being offered employment, I may be requested to take an employment examination. In the event that I have a disability that will affect my ability to take the test, I will inform ITC prior to the test so that a reasonable accommodation can be made. ITC reserves the right to require medical documentation regarding the need for the accommodation.

I certify that the facts contained in this application are true, accurate and complete to the best of my knowledge, and understand that, if employed, falsified statements or omitted material facts on this application may result in disqualification from consideration for employment, or termination from employment, if I have been hired.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated with our without cause, at any time, with or without notice. This provision supersedes any oral or written representation to the contrary, unless in writing and signed by both the President of ITC and the person to whom this writing is directed.

I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excluded, to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to ITC and waive any right that I might have to be provided with notice that they are releasing this information, specifically any notice rights under the Bullard-Plawecki Employee Right-to-Know Act.

I Agree

Employers specifically excluded: