Job Application "*" indicates required fields Name* First Last Date* MM slash DD slash YYYY Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Phone Type Mobile Home Date Available* MM slash DD slash YYYY Position Desired*Job Type* Full Time Part Time Salary Desired*Email* Are you at least 18 years old? Yes No Do you have adequate means of transportation to get to work on time each day? Yes No Are you willing to work overtime whenever scheduled or requested? Yes No Have you been convicted of a criminal offense other than traffic violations within the last seven years? Yes No If yes, give date and detail of each conviction. (A conviction record is not an automatic ban to employment. The nature, seriousness, and date you committed the crime will be considered in relation to the position for which you are applying.)Are you legally authorized to accept employment in this country? Yes No Proof of citizenship or immigration status will be required upon employment.If you are required to operate a motorized vehicle as a condition of employment, can you furnish proof of a Driver's License? Yes No If applying for a Driver position, please answer the following questions:What is your driver's license number?State issued?What is your driver's license class?How many points are currently on your license?EDUCATION/SKILLSHigh SchoolName and Location of SchoolCourse of StudyNo. of Years CompletedDiploma or Degree ReceivedVocational Or Trade SchoolName and Location of SchoolCourse of StudyNo. of Years CompletedDiploma or Degree ReceivedCollegeName and Location of SchoolCourse of StudyNo. of Years CompletedDiploma or Degree ReceivedList all skills you possess that have direct application to the job you are applying for (i.e., mechanical, clerical, technical, etc.)List languages you speak and write fluentlyList any other information which you think has relevance to consideration of this application for this positionWork History - Begin with Present or Last PositionJob 1Employment From (Month - Year) MM slash DD slash YYYY Employment To (Month - Year) MM slash DD slash YYYY Job TitleBeginning SalaryFinal SalaryCompany NameType of businessSupervisor's NamePhoneDescribe your job dutiesReason For LeavingMay we contact? Yes No Job 2Employment From (Month - Year) MM slash DD slash YYYY Employment To (Month - Year) MM slash DD slash YYYY Job TitleBeginning SalaryFinal SalaryCompany NameType of businessSupervisor's NamePhoneDescribe your job dutiesReason For LeavingMay we contact? Yes No Have you ever been discharged from a job or asked to resign? Yes No If yes, please explainAttach Resume Drop files here or Select files Max. file size: 512 MB. PLEASE READ THE FOLLOWING BEFORE SIGNING. If you have any questions regarding the certification and agreement, please ask a member of our staff before signing. APPLICANT'S CERTIFICATION AND AGREEMENT I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Circle Valve Technologies, Inc. to verify their accuracy and to obtain reference information about my work record, my work habits, and my work performance. I hereby release CVT from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for discharge. I understand that, should an employment offer be extended to me and accepted, I will fully adhere to the policies, rules, and regulations of employment of the Company. I understand that either I or the Company may terminate my employment at any time with or without notice or cause. This application is effective for 90 days from the date of application. If you are still available for employment after that time, you must reapply. I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE CERTIFICATION AND AGREEMENT.Signature of Applicant*Date* MM slash DD slash YYYY CAPTCHA
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