ACM - Application
Advanced Cleanroom Microclean hereinafter, "Company" is an Equal Opportunity Employer and does not discriminate against any employee or qualified applicant for employment because of age, religion, sex, race, color, national origin, gender, sexual orientation, covered veteran, or disability status (as defined by applicable law). As a condition of employment, all final external candidates must provide proof of work authorization in the U.S. and successfully pass background check, and/or drug test, and/or credit check as required by and consistent with applicable law.
First Name *
Your answer
Last Name
Your answer
Middle Initial *
Your answer
Current Address *
INCLUDE CITY, STATE, AND ZIP CODE
Your answer
Mailing Address (if different from present physical address)
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
E-Mail Address *
Your answer
How did you find out about this job? *
Your answer
Employment Desired
Position Applying for? *
Are you applying for?
Regular Full - Time Work *
Required
Regular Part - Time Work *
Required
Temporary work, e.g., summer or holidy work? *
Required
What days and hours are you available to work? Or preferred shift? *
Required
If applying for temporary work, during what period of time will you be available? *
Give Approximate Time Frame
Your answer
Are you available to work on weekends? *
Would you be able to work overtime? *
If necessary
If hired, on what date would you be able to start work? *
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Salary Desired?
Your answer
Do you have any friends or relatives working for this company? *
If yes, state name(s) and Relationship
Friend / Relative Name #1
Your answer
Friend / Relative Relationship #1
Your answer
Friend / Relative Name #2
Your answer
Friend / Relative Relationship #2
Your answer
Personal Information
Why are you applying for work at this company? *
Your answer
Have you ever worked for this company before? *
If yes, when and where?
Your answer
Would you have reliable means of transportation? *
To and from work?
Are you at least 18 years old? *
(if under 18, hire is subject to verification that you are of minimum legal age)
If hired, can you prove your a US citizen? *
Can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
Have you, Ever been convicted *
Ever been convicted of a criminal offense (felony or serious misdemeanor)? (Convictions for misdemeanor marijuana related offenses that are more than two years old need not be listed?
If yes, state the nature of the crime(s), when and where convicted, and disposition of the case.
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied may, however, be considered)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Experience, Education, and Training
High School *
Please list name of High School which you attended
Your answer
City / State
Your answer
Did you graduate?
Major Course of Study
Your answer
College / University *
Please list name of College / University you attended
Your answer
Address of College / University
Your answer
Number of years you Attended College / University
Your answer
Did you graduate College / University? *
What was your major course of study?
Other Course of Study
Your answer
Vocational / Business *
Pleas list name and address of vocational/buisiness training and number of years attended
Your answer
Address of Vocational / Business
Your answer
Did you graduate from Vocational / Business?
List course of study (vocational)
Your answer
Option: Many of our customers (clients) do not speak english. *
Do you speak, write of understand any foreign languages?
If yes, which language(s)
Your answer
Do you have any other experience, training, qualifications, or skills that you feel make you especially suited for work at this company? *
If yes, please Explain
Your answer
Have you obtained any special skills or abilities as the result of service in the military?
If so, describe
Your answer
Employment History
List below all present and past employment starting with your most recent employer (last five years is sufficient) Account for all periods of unemplyment. You must complete this section even if attaching a resume.
Most Recent Employer
Name of Employer
Your answer
Telephone No. of Employer
Your answer
Type of Business
Your answer
Address of Employer
Your answer
Your Supervisors Name
Your answer
Dates of Employment
Your answer
Your Positions and Duties
Your answer
Reasons for Leaving
Your answer
May we contact for a reference?
Next Most Recent Employer
Name of Employer
Your answer
Telephone No. of Employer
Your answer
Type of Business
Your answer
Address of Employer
Your answer
Your Supervisors Name
Your answer
Dates of Employment
Your answer
Your Positions and Duties
Your answer
Reasons for Leaving
Your answer
May we contact for a reference?
Next Most Recent Employer
Name of Employer
Your answer
Telephone No. of Employer
Your answer
Type of Business
Your answer
Address of Employer
Your answer
Your Supervisors Name
Your answer
Dates of Employment
Your answer
Your Positions and Duties
Your answer
Reasons for Leaving
Your answer
May we contact for a reference?
Please explain any gaps in your employment history (If medically-related, do not include nature or severity of condition or current status)
Your answer
References
List below three persons not related to you who have knowledge of your work performances within the last 5 years.
Reference #1
First / Last Name *
Your answer
Telephone No. *
Your answer
Ocupation *
Your answer
No. of Years Acquainted *
Your answer
Reference #2
First / Last Name *
Your answer
Telephone No. *
Your answer
Occupation
Your answer
No. of Years Acquainted *
Your answer
Reference #3
First / Last Name *
Your answer
Telephone No. *
Your answer
Occupation *
Your answer
No. of Years Acquainted
Your answer
Please Read Next Section Carefully
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *
Required
I hereby authorize the Company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the Company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from and all claims, demands or other liabilities arising out of or in any way related to such investigation or disclosure. *
Required
I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and me be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the Company's designated representative. *
Required
Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records, obtained by the Company unless I mark the checkbox below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below. *
Required
I waive the receipt of a copy of any public record described in the paragraph above
Date of Completed Application *
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Your Name Here *
It is hereby declared that the information and particulars furnished above are true and correct to the best of my/our knowledge and belief and nothing has been concealed.
Your answer
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