EPTAM Precision Plastics, New Hampshire    |    EPTAM Precision Metals, Colorado    |    EPTAM Precision Molding, New Jersey

Employment Application

Consistent with federal and/or state laws, EPTAM Precision ("Company") does not discriminate in employment and applications for employment because of sex, age, race, color, religious creed, sexual orientation, national origin, marital status, ancestry, service in the armed forces of the United States, disability or other protected classifications. Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to complete the application and/or with the interview process should notify a representative of the Human Resources Department. In addition, EPTAM is an Affirmative Action Employer. Any Applicant who wishes to self-identify for affirmative action consideration based on race or sex should complete the tear sheets attached.

*Required fields are highlighted

Personal Information

Today's date is Nov 30, 2020

First Name

Middle Name

Last Name

Mailing Address

City

State

ZIP

Email

Phone

Referred By


Employment Desired

Position
Quality Engineer (Metrology) at EPTAM Precision Metals | Colorado Springs, CO

Are you currently employed:
May we inquire of your present employer:

Date you can start


Shift Desired

Salary/Rate Desired


Have you ever applied here?
If so, when?

Have you ever been employed here?
If so, when?

Are you related to any employee of EPTAM Precision?
If so, who?

Are you under the age of 18?

If hired, can you provide the necessary documents to verify you are authorized to work in the U.S.?

Are you able to perform the essential functions of the job(s) for which you are applying, with or without reasonable accommodation?
(If you have questions about the functions of a job, please contact us before completing this application)

In case of emergency, who should we notify?

Emergency Phone



Education History

High School

Name

Number of Years Attended

Did you graduate?

Subjects Studied


College or University

Name

Number of Years Attended

Did you graduate?

Subjects Studied


Vocational, Business, Trade or Correspondence

Name

Number of Years Attended

Did you graduate?

Subjects Studied


Subjects of Special Study/Special Training/Skills which may qualify you to perform the job-related functions of the position for which you are applying.


U.S Military or Naval Service? (Rank)



Employment History

It is very important that you present an accurate picture of how your experience qualifies you for employment. Starting with your most recent position, list all experience. Use additional sheets if necessary. Your qualifications will be initially determined based on this application. In completing this section, you may include any verified work performed on a volunteer basis, and may explain any gaps in employment in comments section on this page. Please be complete and specific to avoid disqualification. List present or most recent position first.


Last or Present Employer

Start Date

End Date (leave blank if present)

Company

Address

Supervisor

Phone

Salary/Compensation

Position Held & Duties

Reason For Leaving


Next to Last Employer

Start Date

End Date

Company

Address

Supervisor

Phone

Salary/Compensation

Position Held & Duties

Reason For Leaving


Next Employer

Start Date

End Date

Company

Address

Supervisor

Phone

Salary/Compensation

Position Held & Duties

Reason For Leaving


Comments Including voluntary explanation of any gaps in employment.


Have you been convicted of a felony (you may exclude misdemeanors) at any time?
If yes, please describe fully the criminal conviction(s), listing the nature of the offense, the date of the offense and any period of imprisonment or probation:


References

List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.


Reference Name

Phone

Years Known


Reference Name

Phone

Years Known


Reference Name

Phone

Years Known



Voluntary Self-Identification

Applicants are considered for all positions for which they qualify without regard to race, color, religion, age, national origin, sex, sexual orientation, disability or any other legally protected status. EPTAM Precision complies with applicable federal and state laws, including affirmative action regulations and responsibilities.

This data is for periodic government reporting and will be kept in a Confidential File separate from the Application for Employment. It will not be used in considering and/or selecting applicants for employment. Submission is voluntary. Failure to supply this information will not jeopardize or adversely affect any consideration you may receive for employment, or later advancement of employment.

Solely to help us comply with required record-keeping, reporting and other legal requirements, please complete this section of the application.

We appreciate your cooperation.

Select ONE option in each category below:


Gender




Race/Ethnic Group


- A person of Mexican, Puerto Rico, Cuban, Central or South America, or other Spanish culture or origin, regardless of race.

(not Hispanic or Latino) - A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment.

(not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

(not Hispanic or Latino) - A person having origins in any of the Black racial groups of Africa.

(not Hispanic or Latino) - A person have origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Island.

(not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.

(not Hispanic or Latino)- All persons who identify with more than one of the Above five races.


Please identify where you learned about an employment opportunity with this organization.











Applicants Certification and Agreement

Please read carefully


"I confirm that the information being provided is true and correct to the best of my knowledge, and I understand that if I am employed, any misrepresentation or material omission made by me on this application may result in cancellation of this application or immediate discharge from the Company's service, whenever it is discovered. I confirm that I have a sincere intent and no other purpose in applying for a job with EPTAM Precision.

I understand that EPTAM Precision is a Drug-Free Workplace as a government contractor. If employed, EPTAM's policies would prohibit me from possessing, using,or being under the influence of alcohol or illegal drugs at any time during the workday or anywhere on EPTAM Precision premises.

I understand that any employment is "at will" and may be terminated at any time, with or without cause, by either myself or EPTAM Precision. No one in our organization has the authority to enter into any agreement for employment for a specific period of time, or to make any other representations or agreement inconsistent with this policy of at-will employment, unless it's in writing and signed by the President. In addition, anyone that is hired by the company could be asked to work on any shift and be expected to travel overnight on behalf of the company.

My signature on this form authorizes schools, law enforcement agencies, previous employers, attorneys, judges, court clerks, agencies of city, county, state and federal governments to release and freely discuss all information relevant to my employment including: Attendance, Conduct, Work Habits, Job Assignments, Termination, Education, and Pay History. I authorize EPTAM to obtain such information, and release EPTAM Precision from all liability for any damage that may result from its utilization of such information. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

I understand it is this Company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA. The Company does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law.

I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.

I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.


Your Digital Signature

Today's date is Nov 30, 2020

All applications will be kept on file for 1 year from date of submission.