Careers / Employment Application Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status. Position Title * Name * First Name Last Name Email * Phone (###) ### #### Desired Salary $ Address Address 1 Address 2 City State/Province Zip/Postal Code Country Are you a U.S. citizen and/or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.) Yes No Are you willing to provide your Social Security Number to Celeris Systems, Inc. (Celeris) when requested for use in payroll processing, background checks, U.S. DoD security clearance? * Yes No Do you hold a current U.S. DoD or other Security Clearance? Yes No Employment Desired: Are you looking for full-time employment? * Yes No Are you available for part-time work? Yes No Will you relocate? Yes No Education: High School Name, State, Degree Earned: College 1 Name, State, Degree Earned: College 2 Name, State, Degree Earned: Post-College Name, State, Degree Earned: Other Training or Certifications Are you planning to continue your studies? Yes No If yes, where and what courses of study? In addition to your work history, are there any other skills, qualifications, or experience that we should consider? Employment References (List up to three employment references within the last ten years): Employment Reference #1 Name of Current or Former Employer: Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Start Date MM DD YYYY End Date MM DD YYYY Responsibilities Reason for Leaving (if applicable) Employment Reference #2 Name of Current or Former Employer: Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Start Date MM DD YYYY End Date MM DD YYYY Responsibilities Reason for Leaving (if applicable) Employment Reference #3 Name of Current or Former Employer: Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Start Date MM DD YYYY End Date MM DD YYYY Responsibilities Reason for Leaving (if applicable) Personal References (List three personal references, not related to you, who have known you for more than one year): Reference 1 First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email Phone (###) ### #### Years Known Reference 2 First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email Phone (###) ### #### Years Known Reference 3 First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email Phone (###) ### #### Years Known Please Upload Your Resume * FileField; MaxSize=1000KB; Multiple; addText=Upload Read Before Electronically Signing: I certify that all of the information provided by me on this application is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application. I authorize my previous employers, schools, or persons listed as references to give any information regarding my employment or educational record. I agree that this company and my previous employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this application. In the event of any employment with this company, I will comply with all rules and regulations as set by the company in any communication distributed to the employees. In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide approved documentation to the company that verifies my right to work in the United States on the first day of employment. I have received from the company a copy of the approved documents that are required. I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements. Please enter your name in the text box below * First Name Last Name Today's Date * MM DD YYYY Thank you, we’ll be in touch shortly!
