Step 1 of 5 20% First Name* Middle Name* Last Name* HiddenName First Middle Last Email Address* Number and Street City State / Province / Region ZIP / Postal Code Day Phone:* Alternate Phone: Position(s) you are applying for? Availability Full TIme Part Time Temporary HiddenAvailability: Full-Time Part-Time Temporary Where did you hear about opportunities with TSI? Have you applied with us before? Yes No If yes, please provide dates, positions held: Are you at least 18 years of age?(Employment is subject to verification of minimum legal age) Yes No Have you ever been convicted of a violation of the law except for a minor traffic violation? Yes No If yes, please explain:(A conviction does not necessarily cause rejection of your application. Rather, such factors as age and date of conviction, nature and seriousness of the crime, and rehabilitation will be considered.) If the position applied for requires driving, do you have an appropriate license? Not Applicable Yes No If the position applied for requires overnight travel or an ability to work unusual hours, can you meet that requirement? Not Applicable Yes No How soon can you report to work? What is your desired salary? Do you have an active DoD security clearance? Yes No If so, at what clearance level? a. Have you ever held a DoD security clearance? When? At what level? b. Have you ever been denied a request for any government security clearance? Yes No If you do not currently have a security clearance, are you eligible for a DoD security clearance? Yes No a. Are you a US citizen?* Yes No b. Have you ever been convicted of a felony?* Yes No Applicant Name (Print) Date Month Day Year Schools, Name/Location, Years Completed, Diploma/Degree StudiesHigh School College/University College/University Technical/Other Honors/Awards SPECIALIZED TRAINING AND JOB-RELATED SKILLSInclude apprenticeships, business-related extracurricular activities, qualifications from employment and other experiences.EMPLOYMENT HISTORYList your entire employment history and account for any gaps in employment. List last or present employer first; includes military service. If you need additional space, please attach a separate sheet of paper providing this same information. Employer Phone Address Street Address City State / Province / Region ZIP / Postal Code May we contact? Yes No Position Supervisor Dates of Employement HiddenDates of Employment MM slash DD slash YYYY Duties/ResponsibilitiesReason for Leaving Have you ever been discharged or asked to resign from a job? Yes No If yes, explain: Applicant Name (Print) Dates MM slash DD slash YYYY Additional Employers Add Second Employer Employer Phone Address Street Address City State / Province / Region ZIP / Postal Code May we contact? Yes No Position Supervisor Dates of Employment HiddenDates of Employment MM slash DD slash YYYY Duties/ResponsibilitiesReason for Leaving Additional Employer Add Third Employer Employer Phone Address Street Address City State / Province / Region ZIP / Postal Code May we contact? Yes No Position Supervisor Dates of Employment HiddenDates of Employment MM slash DD slash YYYY Duties/ResponsibilitiesReason for Leaving Additional Employer Add Fourth Employer Employer Phone Address Street Address City State / Province / Region ZIP / Postal Code May we contact? Yes No Position Supervisor Dates of Employment HiddenDates of Employment MM slash DD slash YYYY Duties/ResponsibilitiesReason for Leaving Additional Employers Add Fifth Employer Employer Phone Address Street Address City State / Province / Region ZIP / Postal Code May we contact? Yes No Position Supervisor Dates of Employment HiddenDates of Employment MM slash DD slash YYYY Duties/ResponsibilitiesReason for Leaving PROFESSIONAL / TRADE / BUSINESS / CIVIC ORGANIZATIONSYou may exclude those that could tend to indicate race, color, religion, national origin, disability, or other protected status.REFERENCESList three references other than previous employers and relatives. 1st REFERENCEName Phone Address Street Address City State / Province / Region Relationship 2nd REFERENCEName Phone Address Street Address City State / Province / Region Relationship 3rd REFERENCEName Phone Address Street Address City State / Province / Region Relationship APPLICANT'S ACKNOWLEDGEMENT OF UNDERSTANDINGThis Employment Application shall be considered active for not more than 45 days. After that time, applicants will be required to complete a new application form. I certify that the information contained in this Application is true and complete to the best of my knowledge. I understand that any misrepresentation or omission of any facts on my application, resume, or during any interview, may result in refusal of employment or, if employed, termination from the Company’s employment. I understand that the Company may check on job references and other information. I authorize my former employers and others to give information to the Company and hereby release my former employers, others supplying information and the Company, its employees and agents from any liability whatsoever from such disclosure. I have received the separate disclosure informing me that a Consumer Report may be obtained and I authorize the Company to obtain from time-to-time a Consumer Report as defined in the Fair Credit Reporting Act from a consumer reporting agency (such as a credit bureau) concerning me. I understand the Company may use consumer reports in connection with my employment and I agree that they are relevant for this purpose. I will hold the Company harmless from its use of these reports in this manner. Any offer of employment I may receive from the Company is contingent upon my successful completion of the Company’s entire preemployment screening process, including satisfactory completion of any post-job-offer pre-employment physical examination the Company may require. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I also understand that, if employed, I may be required to submit to alcohol or drug screening as a condition of continued employment. In the event I am employed, I acknowledge that any such employment is at-will and that employment and compensation can be terminated, with or without cause and with or without notice, at any time at the option of the Company or myself. I understand that no representative other than the Company CEO has any authority to enter into any agreement for employment for any specified period of time or to make any employment agreement and any representations contrary to the foregoing are expressly disavowed, shall not be binding upon and should not be relied upon by any prospective or existing employee, unless made in writing and signed by the Company CEO. I further acknowledge that any personnel manual, handbook, publication, policy, procedure, rule, or regulation that may now or in the future apply to me is not contractual in nature and does not modify the foregoing at-will employment relationship. Signature of Applicant Date MM slash DD slash YYYY DISCLOSURE FOR CONSUMER REPORTTransformation Systems Inc. may obtain a Consumer Report for employment purposes. I acknowledge receipt of this Disclosure: Applicant’s Signature: Date MM slash DD slash YYYY Δ
