Step 1 of 4 25% Application for EmploymentAs an Equal Opportunity Employer, BCI does not discriminate on the basis of race, color, religion, sex, national origin, age disability, or veteran status. All information provided in this application will be treated confidentially and will be used only to help ensure the best use of your abilities if you are employed by us.Name: First Last Date: Date Format: MM slash DD slash YYYY Email: Phone:Address:City:State:Zip:Social Security #:Driver's License #:Expiration Date: Date Format: MM slash DD slash YYYY Are you legally permitted to work for any employer in this country, without restriction?YesNoHave you ever been convicted of a felony?YesNoA positive response is not an automatic bar to employment with the company. The offense for which the person was convicted in relation to the position to which they have applied, will be considered.If yes please explain:On what date are you available for work? Date Format: MM slash DD slash YYYY Education:(if not provided in as resume)Select all that apply: High School College/University Post Graduate Business/Trade/Technical Other High School - School and DegreeCollege/University - School and DegreePost Graduate - School and DegreeBusiness/Trade/Technical - School and DegreeOther - School and DegreeProfessional References:NameCompany & TitleTelephoneEmail Please list three Employment HistoryBeginning with most recentEmployment History ListCompanyBusiness TypeSupervisorSupervisor TitleSupervisor PhonePosition HeldEmployed FromEmployed ToEnding SalaryReason for LeavingMay we Contact? Position you are applying for:Salary you will require: By signing my name below, I certify that the answers given in this application for employment are true and correct to the best of my knowledge. I understand that a drug test and background check will be required, and employment is contingent upon passing. I consent to this procedure should I be hired. I authorize investigation of all statements made in this application, as many as may be necessary in reaching an employment decision. I understand that any false or misleading information given in this application or during a pre-employment interview, including a failure to disclose requested information, shall be sufficient cause for dismissal. Employment at Bachelor Controls, Inc. is on an at will basis.Applicant Signature:Date: Date Format: MM slash DD slash YYYY