Generic Application Form with E-Signature

Employment Application

EMPLOYMENT APPLICATION FOR COMTEC SOLUTIONS, LLC

We are an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, religion, creed, national origin, ancestry, alienage or citizenship status, age, disability, gender (including pregnancy, childbirth and related medical conditions), sexual orientation, genetic information/characteristics, veteran or military status, marital status, or any other characteristic protected by applicable federal, state or local laws.

ComTec Solutions, LLC. must comply with the International Traffic in Arms Regulations (ITAR) issued by the United States Department of State, Department of Defense Trade Controls. Because of ITAR, the company must limit employment opportunities to US citizens or lawful permanent residents of the United States, or those admitted as a refugee or granted asylum.

We will endeavor to make a reasonable accommodation/modification to the known physical or mental limitations of a qualified applicant with a disability to assist in the hiring process, unless the accommodation would impose an undue hardship on the operation of our business, in accordance with applicable federal, state and local law. If you believe you require such assistance to complete this form or to participate in the interview process, please contact Kristine Caronna at 585-621-9303.

THIS EMPLOYMENT APPLICATION IS NOT AN EMPLOYMENT CONTRACT.

GENERAL INFORMATION
NAME	EMAIL	DATE 01-01-1970
ADDRESS	PRIMARY PHONE	OTHER PHONE
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.? Pursuant to the Immigration Reform and Control Act of 1986, all applicants who are offered employment must produce documents establishing their identity and authorization for employment in the United States. These documents must be produced no later than seventy-two (72) hours after employment commences. In addition, all new hires will be required to verify their employment authorization under oath by signing INS Form I-9.		WHEN WILL YOU BE ABLE TO BEGIN WORK? 01-01-1970
IF YOU ARE UNDER 18 YEARS OF AGE, DO YOU HAVE A WORK PERMIT OR OTHER APPROPRIATE DOCUMENTATION?

EMPLOYMENT INFORMATION
POSITION DESIRED
HOURS AVAILABLE	ARE YOU WILLING TO WORK OVERTIME?
SALARY/RATE DESIRED	HOURS DESIRED
HAVE YOU EVER BEEN EMPLOYED BY US? If yes, give date, location, title, name of supervisor and reason for leaving:
HAVE YOU EVER APPLIED FOR EMPLOYMENT WITH US? If yes, give date:

PROFESSIONAL REFERENCES

EDUCATIONAL HISTORY
NAME AND LOCATION	COURSE OF STUDY	DEGREE/DIPLOMA/ GED (Yes or No)
HIGH SCHOOL / GED
COLLEGE
GRADUATE SCHOOL
OTHER SCHOOLING

EMPLOYMENT HISTORY
Instructions for completing this section: Please print and list all prior employers, beginning with your PRESENT or MOST RECENT employer. Complete all requested information in full. DO NOT include overtime, bonus, commissions, etc. in the base salary information.
EMPLOYER (1st most recent)		EMPLOYER (2nd most recent)
Address		Address
Dates Employed		Dates Employed
From	To	From	To
Supervisor	Phone	Supervisor	Phone
Position(s) Held		Position(s) Held
Duties		Duties
Reason for Leaving		Reason for Leaving
EMPLOYER (3rd most recent)		EMPLOYER (4th most recent)
Address		Address
Dates Employed		Dates Employed
From	To	From	To
Supervisor	Phone	Supervisor	Phone
Position(s) Held		Position(s) Held
Duties		Duties
Reason for Leaving		Reason for Leaving
IS THERE ANY REASON WHY WE SHOULD NOT CONTACT ANY CURRENT OR FORMER EMPLOYER FOR A REFERENCE?
IF YES, PLEASE IDENTIFY THE EMPLOYER AND EXPLAIN WHY NOT.

Applicant Cover Letter:

Applicant Resume:

Applicant’s Statement and Certification

I have read and fully understand the questions asked in this application. I certify that all of the answers I have given are true, accurate and complete. I understand and agree that any omission, misrepresentation, false or incomplete statement by me of any fact from or on this application or during any interview may cause ComTec Solutions, LLC. to eliminate me from further consideration for employment, or, if hired, to may lead to disciplinary action, up to and including immediate termination of my employment, whenever it is discovered.

Unless I noted otherwise, and to the extent permitted by federal, state or local law, I authorize ComTec Solutions, LLC. to verify all statements contained in this application and/or my resume, to contact all my employment references and personal references, as well as the educational institutions I have attended. I further authorize ComTec Solutions, LLC. to inquire about, investigate and obtain copies of any records which relate to me from my former employers and educational institutions. To the extent permitted by federal, state and local law, I hereby release ComTec Solutions, LLC. and all affiliated persons and entities, as well as any person or institution that provides ComTec Solutions, LLC. with any lawful information about me, from any and all liability whatsoever resulting from any such lawful inquiry, investigation or communication.

I understand that any hiring decision is contingent upon my successful completion of all of ComTec Solutions, LLC.’s lawful pre-employment checks, which may include a background check. I agree to execute any consent forms necessary for ComTec Solutions, LLC. to conduct its lawful pre-employment checks.

I agree to comply with and acknowledge the procedures, policies and practices of ComTec Solutions, LLC. in accordance with applicable law. In addition, I understand that ComTec Solutions, LLC. and all plan administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms and conditions of employment.

I understand and agree that nothing in this application shall constitute an offer, a contract or a guarantee of employment for a specific period of time. If hired, I understand that my employment with ComTec Solutions, LLC. is on an at-will basis, unless otherwise prohibited by state law, which means that my employment may be terminated with or without cause and with or without notice at any time, at the will of ComTec Solutions, LLC. or me. I further understand that no representative or agent of ComTec Solutions, LLC., other than the President has the authority to enter into any agreement for employment for any specific period of time, or to make an agreement contrary to the foregoing. I also understand that any agreement modifying my at-will employment status must be in writing and signed by the President.

If hired, I understand that proof of authorization to work in the U.S. will be required in accordance with applicable law. I further understand, if hired, ComTec Solutions, LLC. may request that I execute other documents (including, but not limited to, agreements regarding training, trade secrets, confidential information and conflicts of interest).

ComTec Solutions, LLC. considers this employment application to be a part of the personnel record.

I understand that if offered employment, my employment with ComTec Solutions, LLC. may be subject to any or all of the following, depending on the job position and in accordance with applicable law: successful completion of a post-offer/pre-employment drug test, a review of references, a consumer report/background check and collection and review of other background information including criminal conviction information, all in accordance with applicable law. I understand that I may be required to complete necessary consent forms in order for ComTec Solutions, LLC. to conduct background checks and/or a drug test.

By signing below, I declare that I have read and agree to the above statements contained in this Applicant Statement and Certification.

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ComTec Solutions https://www.comtecsolutions.com

Timestamp

Audit

February 7, 2019 11:48 am EDT

Employment Application Uploaded by ComTec Solutions - asalsedo@comtecsolutions.com IP 98.1.1.91

February 8, 2019 3:21 pm EDT