Swiss Automation, Inc. Application for Employment Step 1 of 5 0% Instructions: Please complete the entire application. It is the policy of Swiss Automation, Inc. to provide equal opportunity with regard to all terms and conditions of employment. Swiss Automation, Inc. complies with all federal and state laws prohibiting discrimination on the basis of race, color, religion, sex, national origin, disability, veteran status, age or any other protected characteristic. Your InformationName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Home Phone*Cell Phone* Employment DetailsShift Preference 1 2 3 Any Position Applied For* Date available for work MM slash DD slash YYYY Type of work desired Full-time Part-time Seasonal Temporary How were you referred to Swiss Automation, Inc.? Have you ever been employed here before?* Yes No If Yes, give dates If you are under 18 years old, can you provide a work permit if required? Yes No Are you able to perform the “essential functions” of the job for which you are applying (with or without reasonable accommodation)? This question is not designed to elicit information about an applicant’s disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law. Yes No Need more information about the job’s “essential functions” to respond Education BackgroundHigh SchoolName of School Location Course of study Did you graduate? Yes No Degree or diploma Years Completed CollegeName of School Location Course of study Did you graduate? Yes No Degree or diploma Years Completed Vocational Training/OtherName of School Location Course of study Did you graduate? Yes No Degree or diploma Years Completed Employment ExperienceEmployer #1Name PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Work Performed Reason for Leaving May we contact this employer? Do not contact this employer Employer #2Name PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Work Performed Reason for Leaving May we contact this employer? Do not contact this employer Employer #3Name PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Job Title Supervisor Starting Date MM slash DD slash YYYY Ending Date MM slash DD slash YYYY Work Performed Reason for Leaving May we contact this employer? Do not contact this employer Final InformationSkills and QualificationsList any special training skills, licenses, and/or certificates that may assist you in performing the position for which you are applying.Anti-Discrimination ClauseSwiss Automation, Inc. does not tolerate unlawful discrimination or harassment based on sex, race religion, national origin, citizenship, age, disability, or any other protected status infer applicable federal, state, or local law. No question on this application is used to limit or exclude an applicant from employment consideration. Swiss Automation, Inc. Takes all harassment complaints seriously and investigates each one promptly and thoroughly. I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. If hired, I agree to conform to Swiss Automation, Inc.’s rules and regulations, and I understand that these rules and/or the employee handbook do not form a contract of employment either expressed or implied, and I agree that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at either my or Swiss Automation Inc.’s option. I also understand and agree that the terms and conditions of my employment may be changed with or without cause and with or without notice, at any time by Swiss Automation, Inc. I understand that no Swiss Automation, Inc. representative, other than its president, and then only in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain all information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding Swiss Automation, Inc., its agents, employees or representatives for seeking, gathering and using truthful and nondefamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I have read and agree to the Applicant Statement above.* I Agree Type your electronic signature here* Resume and FilesUpload Resume (.doc, .docx, .pdf only)Accepted file types: doc, docx, pdf, Max. file size: 5 MB.Upload Other (.doc, .docx, .pdf only)Accepted file types: doc, docx, pdf, Max. file size: 5 MB.CAPTCHAEmailThis field is for validation purposes and should be left unchanged.