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Employment Application

Employment Application Form

Step 1 of 4

25%

Your Personal Information

Your Name(Required)
Current Mailing Address
Check the following options you would consider(Required)
Are you subject to any type of agreement with a current or former employer or entity that would restrict your ability to work at ICS?(Required)
(e.g., non-compete, non-solicitation).

Education and Training

High School
Degree Received
GED
Degree Received
Colleges*
Degree Received
Graduate School
Degree Received
Trade School
Degree Received
* Only list colleges or universities accredited by the Department of Education (DOE). The DOE maintains a database of accredited institutions at http://ope.ed.gov/accreditation. It is your responsibility to verify accreditation.
List coursework undertaken or degree/diploma received from an unaccredited college, as well as any other education, training, special skills or certificates/licenses that your possess related to the job.
Professional License/Cert. #
Professional License/Cert. Type
Issuing Agency
State issued
Expiration Date
 
Can you, after employment, submit verification of your legal right to work in the United States?
Are you 16 years old or over?
Age:
Within the past 7 years, have you been employed, or are you currently employed by ICS?
Do not identify your marital status in your response.
Do you have any relatives currently working at ICS?
Do you have any relatives serving on the Board of Directors for ICS?

Employment History

(List all work experience beginning with the present or most recent job. ICS will contact all previous employers to verify your employment. Please list your current or most recent employer first and indicate whether you are currently employed in the boxes provided. ICS will not contact your current employer without permission. You may also include any volunteer and/or military work.)

Current or most recent job

Type of employment
May we contact?

Previous Employment

Add more rows if needed
Row
Address
Type of Employment
May we contact?
Row 1
Address
Type of Employment
May we contact?
Business References (List three individuals, in addition to listed employment references, known to you for at least three years.)(Required)
Name
Occupation/Association
Telephone
Email Address
 

Please include any other information you think would be helpful to us in considering you for employment, such as additional work experience, articles/books published, activities, honors received, etc. You may omit all information that would indicate age, sex, sexual orientation, race, religion, color, national origin or disability or any other protected class.

Agreement (Please read the following statement carefully.)

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that falsification or significant omission of information requested in this application or in the application process may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.

I authorize all persons listed above (and on the accompanying resume, if any) to give ICS any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and ICS, from liability for any damage that may result from furnishing same to ICS.

If employed by ICS, I agree to abide by the policies and procedures of ICS, which include the ICS Anti-Harassment Policy. I further understand that my employment can be terminated, with or without cause or notice, at any time, at the discretion of ICS or myself. I further understand that no manager or representative of ICS other than the president of ICS has any authority to enter into any agreement, oral or written, on behalf of ICS for a term of employment or to make any assurance or promise of continued employment.

DRUG TESTING: I understand and agree that, subject to applicable law, I may be required to take a drug and alcohol screening test. I also understand that if I test positive for the presence of drugs or alcohol, I will be ineligible for employment with the company.

FOR ARIZONA APPLICANTS: To the extent required by applicable law, a smoke free workplace is maintained.

FOR MASSACHUSETTS APPLICANTS: Under Massachusetts law, it is unlawful in Massachusetts to require or administer a lie detector test as condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

FOR RHODE ISLAND APPLICANTS: The company is subject to chapter 29-38 of title 28 of the General Laws of Rhode Island and is therefore covered by the state's Workers' Compensation Law.

FOR CALIFORNIA APPLICANTS
I further understand that ICS may obtain public records about me as part of an internal background investigation and that I may waive my right to receive a copy of such public records by checking this box:

Sign And Date Form

For Maryland Applicants Only

Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a lie detector or similar test. An employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100.

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