Online Application

Date

Let's get acquainted.

Name*

First Middle Last

Email*

Phone

Cell

Address

Street Address Address Line 2 City State ZIP Code

Who referred you to us, or how did you hear about us?

Do you know anybody currently sporting the Green Shirt?

Yes
No

State name(s) and relationship:

How can you help us?

What position are you applying for?*

Type of employment:

Full-time work
Part-time work
Temporary work (for example cooperative education employment)

If hired on, on what date can you start working?

Are you under any obligations or terms of a non-compete agreement?

Yes
No

What took you so long?

Below, please describe the last three past and present employment positions including military service. List last employer first. Please account for all periods of unemployment.

Please find this information within the attached resume. (Check the box to upload resume.)

NOTE: If you did NOT include ALL the below information please fill in the name of employer with any missing information.

Resume*

First Employer

Start Date

End Date

Name of Employer

Business Type

Name of Supervisor

Supervisor Email

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position & Duties

Reason for leaving

May we contact this employer for reference?

Yes
No

Second Employer

Start Date

End Date

Name of Employer

Business Type

Name of Supervisor

Supervisor Email

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position & Duties

Reason for leaving

May we contact this employer for reference?

Yes
No

Third Employer

Start Date

End Date

Name of Employer

Business Type

Name of Supervisor

Supervisor Email

Phone

Address

Street Address Address Line 2 City State ZIP Code

Position & Duties

Reason for leaving

May we contact this employer for reference?

Yes
No

What do you know?

Please find this information within the attached resume.

NOTE: If you did NOT include ALL the below information, please fill in the name of the school with any missing information.

High School

GPA

College/University

School Name	Start	Graduated	GPA	Major	Minor

Technical/Business/Other

School Name	Start	Graduated	GPA	Major	Minor

Military

Do you have any experience, certifications, training, qualifications or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us?

We're intrigued! Tell us more!

What do you like to do in your spare time?

What’s the best job you’ve ever had? What made it the best?

How will you enhance our culture?

When was the last time you appreciated a co-worker? How?

Bonus Round

Define what responsiveness is to you and why it’s important.

Who has the scoop?

List the names and contact information of three references, excluding relatives and/or personal friends, who can supply us with professional references.

Please find this information within the attached resume.

NOTE: If you did NOT include ALL the below information please fill in the name of your reference with any missing information.

References

Name	Phone	Email	Address	Occupation

The stuff we have to ask for.

Input 1*

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including and misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by Choice One Engineering, terms for my immediate expulsion for the company.

Input 2*

I understand that if I am employed, my employment is not definite and I can be terminated at any time either with or without prior notice, and by either me or Choice One Engineering.

Input 3*

I permit Choice One Engineering to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

Input 4*

Choice One Engineering has strict policies regarding the use of alcohol or drugs and other controlled substances. Prior to employment you will be required to take a pre-employment drug urine test. The results of these tests will be used to determine your employment eligibility. Also, from time to time throughout your employment Choice One Engineering reserves the right to test our employees for drugs and alcohol pursuant to Choice One Engineering company policy on illegal drugs, alcoholic beverages, firearms, and weapons

Applicant's Signature*

Date*

Choice One is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a company representative.

Phone

This field is for validation purposes and should be left unchanged.

Let's get acquainted.

How can you help us?

What took you so long?

What do you know?

We're intrigued! Tell us more!

Bonus Round

Who has the scoop?

The stuff we have to ask for.

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