Submit a General Application

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:
Supported formats: Word, PDF, RTF, Text, and HTML.
  - or Upload from:
 
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Application for Employment
Please complete the application.
PERSONAL INFORMATION
* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment):
Yes   No
* Are you at least 18 years or older? (If no, you may be required to provide authorization to work):
Yes   No
* Have you ever worked for this Company before?:
Yes   No
If Yes, please provide details (Where/When/Job Title):
* Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?:
Yes   No
If no, please explain:
* When would you be available to begin work?:
* Type of employment desired:
Full-Time   Part Time   Seasonal   Contract

EMPLOYMENT DESIRED
* Hourly rate/salary desired:
* Are you currently employed?:
Yes
No
If so may we inquire of your present employer?:
Yes   No
If presently employed, why are you considering leaving?:
:
School 1 Name & Location:

EDUCATION
Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location Did you Graduate? Degree Received Subjects Studied/Major
Yes   No
Yes   No
Yes   No

Employer 1 From:

EMPLOYMENT HISTORY
Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:

EMPLOYER 2

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:

EMPLOYER 3

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:

REFERENCES Please provide three references (not relatives).

Name Relationship Phone Number Email

AUTHORIZATION
The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

* Signature (type name):
* Date:
General Questions
* Do you have a bachelors degree?
Yes
No
* Would you be willing to relocate?
Yes
No
* Would you be able and willing to travel as needed by the job?
Yes
No
* What minimum salary do you require?
What is the highest Math class taken?
* How many hours per week do you spend sharpening your skills?   What skills are you improving?
Provide the top three characteristics you would like your manager to pocess?
Provide the top three characteristics you would like your team members to pocess?
Do you perform community service on a regular basis?
Yes
No
If so, please describe.
Do you have a passion for learning?
Yes
No
If so, please provide examples supporting your passion.
General Technology Questions
Please indicate your level of expertise for the following technologies. Please use the following definitions to determine the appropriate rating.

Novice: Novice means you know too little the skill to be able to perform the skill to any acceptable standard. Novices must be taught or shown the basics of what they need to do to be productive. The learning strategy of a novice is instructional.

Competent: Competent means you can perform the skill and tasks to basic standards. They have had basic training and may require more coaching and practice. The learning strategy of a competent worker is primarily to request assistance to do the job better.

Experienced: Experienced can vary their performance based on unique situations. Experienced workers often encounter variables and unpredictable sets of challenges, and are therefore required to access knowledge and performance resources on demand. Experienced workers must also possess the ability to search resources in ways that are flexible and customization to them, depending on the situation. The learning strategy of an experienced worker is typically to request assistance to help them find what they need or to search for information from multiple sources.

Master/Expert: Masters and experts create new knowledge and invent new and better ways to utilize the skill and can teach others how to do it. Masters/experts are typically unique individuals that seek to learn in a unique way, primarily through collaboration, research, and problem solving. The learning strategy of a master/expert is to create their own learning.

End-User Applications

* Microsoft Word 2010/2016:
No Experience   Novice   Competent   Experienced   Master/Expert
* Microsoft Excel 2010/2016:
No Experience   Novice   Competent   Experienced   Master / Expert
* Microsoft PowerPoint 2010/2016:
No Experience   Novice   Competent   Experienced   Master / Expert
* Microsoft Access 2010/2016:
No Experience   Novice   Competent   Experienced   Master / Expert
* Microsoft Outlook 2010/2016:
No Experience   Novice   Competent   Experienced   Master / Expert
* Microsoft Publisher 2010/2016:
No Experience   Novice   Competent   Experienced   Master / Expert

Operating Systems

* Windows 10 -  - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert
* Windows 7  - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert
* Windows 8 - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert
* Mac OS - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Unix  - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Andriod  - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert
* IOS - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert

Server Technologies

* Windows Server 2008 / 2012  - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Micrsoft Exchange - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert
* Microsoft Active Directory - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Linux / Unix - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Virtualization (HyperV)  - Setup / Maintaining / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Virtualization (VMware)  - Setup / Maintaining / Troubleshooting:
No Experience   Novice   Competent   Experienced   Master / Expert

Networking Technologies

* TCP/IP Router Configuration:
No Experience   Novice    Competent   Experienced   Master / Expert
* Managed Switch Configuration:
No Experience   Novice   Competent   Experienced   Master / Expert
* Network Topologies:
No Experience   Novice    Competent   Experienced   Master / Expert
* Wireless with Controller - Setup / Configuration / Troubshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Wireless without Controller - Setup / Configuration / Troubshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Mobile Device Management - Setup / Configuration / Troubshooting:
No Experience   Novice   Competent   Experienced   Master / Expert

Health Information Technologies

* Electronic Medical Records - End User:
No Experience   Novice    Competent   Experienced   Master / Expert
* Electronic Medical Records - Administrator:
No Experience   Novice    Competent   Experienced   Master / Expert
* HIPAA Privacy / Security:
No Experience   Novice   Competent   Experienced   Master / Expert
* ARRA HITECH Meaningful Use:
No Experience   Novice   Competent   Experienced   Master / Expert
* Health Information Exchanges / Networks:
No Experience   Novice    Competent   Experienced   Master / Expert
* Personal Health Records:
No Experience   Novice    Competent   Experienced   Master / Expert

Government Information Technologies

* Criminal Justice Information Systems:
No Experience   Novice    Competent   Experienced   Master / Expert
* Accounting Applications:
No Experience   Novice    Competent   Experienced   Master / Expert
* Time and Attendance Applications:
No Experience   Novice   Competent   Experienced   Master / Expert
* Record Mangement Systems:
No Experience   Novice   Competent   Experienced   Master / Expert

Education Information Technologies

* Learning Management Systems:
No Experience   Novice    Competent   Experienced   Master / Expert
* Parent / Teach Portals:
No Experience   Novice    Competent   Experienced   Master / Expert

Cloud Technologies

* Disaster Recovery / Backups - Configuration / Troubleshooting:
No Experience   Novice    Competent   Experienced   Master / Expert
* Remote Management and Monitoring:
No Experience   Novice    Competent   Experienced   Master / Expert
* Office365 - End User:
No Experience   Novice    Competent   Experienced   Master / Expert
* Office365 - Administrator:
No Experience   Novice    Competent   Experienced   Master / Expert
* SharePoint:
No Experience   Novice    Competent   Experienced   Master / Expert

Service Center

* Interacting with Client resolving technical incidents:
No Experience   Novice    Competent   Experienced   Master / Expert
* Ticketing Software:
No Experience   Novice    Competent   Experienced   Master / Expert
* ITIL:
No Experience   Novice    Competent   Experienced   Master / Expert
* Resolving incidents and requests remotely:
No Experience   Novice   Competent   Experienced   Master / Expert

VOIP Technologies

* Asterisk Based VOIP Technologies:
No Experience   Novice    Competent   Experienced   Master / Expert
* Non Asterisk Based VOIP Technologies:
No Experience   Novice    Competent   Experienced   Master / Expert
* IP Phones:
No Experience   Novice    Competent   Experienced   Master / Expert

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