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AERT Employment Application

An Equal Opportunity Employer

AERT, Inc. requires an accurate and fully completed employment application from all applicants. Please do not write "see resume" in response to any question. The information you provide will be subject to verification.
Personal Data
AERT's policy is to recruit and select qualified candidates and promote on the basis of demonstrated knowledge, experience and training without regard to race, color, gender, age, national origin, citizenship status, marital status, sexual orientation, disability status as a disabled veteran or Vietnam era veteran, in accordance with applicable, federal, state or local laws.
Last Name First Name Middle Name
Address City State  Zip
SSN Home Phone Other Phone

Are you a US citizen?    
Position Desired   Salary Desired  
Geographical Preference      Date Available Click to view Calendar Shift Preference  
Are you willing to relocate?          When?  Click to view Calendar   
Please explain any relocation or travel restrictions.  
Applicants must have current authorization to work in the United States on a full-time basis and must complete an Employment Eligibility Verification Form (I-9), as required by the Immigration Reform and Control Act of 1986 (IRCA).
Are you legally authorized to work in the U.S. on a full-time basis? 
Do you have a non-immigrant temporary visa?  (If yes, indicate category)

How did you hear about A.E.R.T.? (newspaper, friend, agency, other)
Are you below the age of 18?
Have you ever held a security clearance? If yes, specify level: 
Specify agency:
Have you ever applied for a position with AERT? If Yes, when?
Have you had previous employment with AERT? If Yes, specify location and dates.
Have you signed an agreement with any past or present employer not to work for a competitor? If Yes, who?
Have you signed an agreement with your past or present employer assigning any inventions you have or will make or conceive during a specified period following termination of employment?
Are you presently on the board of directors of any company? If Yes, what company?

REFERRAL SERVICE (Mark the appropriate source)
(please specify)
(indicate name and location below)
   (please specify)

UNITED STATES MILITARY SERVICE

EDUCATION (If you are working toward a degree or certificate, please list in the "Other" category.)
School Name and Location Major Minor Graduated? Grade Pt. Avg.
/Out of Total
High School
College/University
College/University
Advanced Study
Tech/Vocational
Military Svc School
Other
Please list academic honors, graduate school thesis, scholarships or fellowships, memberships in academic honorary societies, or participation in or offices held in activities you consider to be professionally related. (Exclude all information indicative of age, sex, religion, color, national origin or disability).
Patents, Inventions, Publications, Research Projects and Professional Certification

EMPLOYMENT HISTORY
Please list the past four positions you have held with the most recent position first.
JOB #1
Company Name Phone  
Address
Starting Date Click to view Calendar
Ending Date Click to view Calendar
Starting Salary
Ending Salary
Other Compensation
Starting Position Held
Last Position Held
Name of Supervisor
Major Duties
Reason for leaving
May we contact this employer prior to employment offered by AERT?  
JOB #2
Company Name Phone  
Address
Starting Date Click to view Calendar
Ending Date Click to view Calendar
Starting Salary
Ending Salary
Other Compensation
Starting Position Held
Last Position Held
Name of Supervisor
Major Duties
Reason for leaving
May we contact this employer prior to employment offered by AERT?  
JOB #3
Company Name Phone  
Address
Starting Date Click to view Calendar
Ending Date Click to view Calendar
Starting Salary
Ending Salary
Other Compensation
Starting Position Held
Last Position Held
Name of Supervisor
Major Duties
Reason for leaving
May we contact this employer prior to employment offered by AERT?  
JOB #4
Company Name Phone  
Address
Starting Date Click to view Calendar
Ending Date Click to view Calendar
Starting Base Salary
Ending Base Salary
Other Compensation
Starting Position Held
Last Position Held
Name of Supervisor
Major Duties
Reason for leaving
May we contact this employer prior to employment offered by AERT?  

SPECIFIC SALES EXPERIENCE

COMPUTER SYSTEMS EXPERIENCE
HARDWARE SOFTWARE
  (type)

REFERENCES
Name Business Address Occupation Phone Number Years Known

OTHER INFORMATION
Have you ever been convicted of a crime (Omit minor traffic violations)? A conviction record may not result in an automatic disqualification. The circumstances of each case will be considered. (If yes, explain below).

Please read and sign before submitting this application.
I declare my answers to the questions on this application are true, and if not true, will be grounds for termination, if hired. In being considered for employment, I give the company the rights to investigate my background. I authorize and request all persons, companies and organizations (including credit bureaus, school and law enforcement agencies) to furnish any information about me requested by the company. I release from any liability any person, company or organization furnishing such information.

I understand any employment offer is contingent upon meeting company medical standards which may include a drug test to comply with the Drug-Free Workplace Act of 1988 and Department of Defense regulations. It is further understood that I may be required to furnish proof of citizenship and/or date of birth when reporting to work.

For Required Locations: I have read the AERT, Inc. policy statement on Drugs and the Work Environment and understand that if I am offered a position with AERT, Inc., I will participate in required drug screening.
 I understand that the issuance of this application does not indicate that there are any positions open and does not in any way obligate the company. I understand that I will not be paid for time spent while applying for a position, taking a physical examination or any other processing prior to the beginning of employment. If I am employed by the company, I agree to abide by all company rules and regulations which are in effect or may be established in the future and to comply with the AERT Code of Ethical Conduct.

ALL AERT EMPLOYEES ARE EMPLOYED IN AN "AT WILL" CAPACITY, THIS MEANS THAT EITHER THE EMPLOYEE OR AERT MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND THAT NEITHER PARTY HAS THE OBLIGATION TO BASE THAT DECISION ON ANY REASON OTHER THAN THE INTENT NOT TO CONTINUE THE EMPLOYMENT RELATIONSHIP. ONLY A WRITTEN AGREEMENT EXPLICITLY PROVIDING OTHERWISE, SIGNED BY THE CHAIRMAN OF THE BOARD OF AERT MAY CHANGE THE AT WILL NATURE OF THE EMPLOYMENT RELATIONSHIP.
Type name for your signature: