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Employment Application

Thank you for your recent interest in career opportunities with Human Technologies Corporation. To continue the employment process, complete the form below:

We are proud to be an Equal Opportunity Employer. People with disabilities are encouraged to apply.

HTC is a Tobacco Free Company.

There are positions within HTC subject to a background check. For details please speak with the Human Resources Department.

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Referral Source * Walk-in
Advertisement - Specify:
Employee - Specify:
Relative - Specify:
Government Agency (ie. VESID, OMRDD, etc) - Specify:
Private Employment Agency - Specify:
Other - Specify:

Resume Upload (optional)



Personal Information
 
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am pm
* Yes No
Phone:
Time: am pm
If you are under 18, can you furnish a work permit?
  Yes No
Have you filed an application here before? *
  Yes No
Do you have family/friends who work for HTC? *
  Yes, Name(s): No
Have you ever been employed here before? *
  Yes No
From: To:
Are you legally eligible for employment in the United States? *
  Yes No
Type of employment desired * Full-Time
Part-Time
Temporary
Seasonal
Work Tryout
Are you on layoff and subject to recall? *
  Yes No
Will you relocate if the job requires it? *
  Yes No
Will you travel if the job requires it? *
  Yes No
Are you able to meet the attendance requirements of the position? *
  Yes No
Will you work overtime if required? *
  Yes No
Have you ever been bonded? *
  Yes No
Have you ever been convicted of a crime? *
(Such conviction may be relevant if job related, but does not bar you from employment. Include traffic violations, misdemeanors, felonies, etc.)
  Yes No

Number:
State:

Employment History
 
Most recent/current
Employer
Position
Address
Phone
Supervisor
Salary
Dates of Employment
Reason for Leaving
Job Duties
Employer
Position
Address
Phone
Supervisor
Salary
Dates of Employment
Reason for Leaving
Job Duties
Employer
Position
Address
Phone
Supervisor
Salary
Dates of Employment
Reason for Leaving
Job Duties

Education
 
  Name, City, State Degree / Diploma Type Date
High School
College
College
Graduate School
Business, Trade or Other

References - Give the names of professional references, not related to you, who may be contacted.
 
Name Address Phone Business Years Acquainted
May we request references from:
Your current employer? * Yes No
Your former employer(s)? * Yes No

Skills and Qualifications
 
Affirmative Action Plan Data
 
Applicants are treated during the hiring process without regard to: age, national origin, gender, religion, disability, sexual orientation, veteran status, marital status or any other legally protected status.
As a federal contractor, Human Technologies Corporation complies with all governmental regulations including Affirmative Action. HTC collects data for recordkeeping, reporting and other legal requirements only.
Completing this form is OPTIONAL. If you choose to fill in the requested information, it will not be part of the hiring process. It will be maintained in a confidential file separate from your application and/or personnel file. Information provided or not provided will have no effect on the hiring decision.
   

Ethnic Origin: (choose ONE)

 
 
 
 
 
 

Veteran Status

 
 
 
 

It is understood and agreed upon that any misrepresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from Human Technologies Corporation (HTC) service if I have been employed.

I give HTC the right to investigate all references and to secure additional information about me, if job-related. I hereby release from liability HTC and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

HTC is an Equal Opportunity Employer. HTC does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant's consideration for employment on a basis prohibited by local, state or federal law.

This application is current for 1 year. At the conclusion of this time, if I have not heard from HTC and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time, HTC reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of HTC has the authority to make any assurances to the contrary.

I understand it is HTC's policy to hire qualified individuals with disabilities and to recognize the need for reasonable accommodations that may be required by the ADA.

I further agree to hold harmless those employers, educational institutions and individuals releasing information to HTC regarding my application for employment.

HTC is a Tobacco Free Company.

There are positions within HTC that are subject to a background check. For details please speak with the Human Resources Department.

I have applied for a position at the above indicated facility. I hereby authorize the release of any educational information and/or any information regarding my job performance to HTC and its affiliates.

My name: *

I agree * I do not agree

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