EMPLOYMENT APPLICATION

CONTACT INFORMATION / IDENTIFICATION

First Name(*)
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If hired, verification will be required consistent with federal law.

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EDUCATION

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EMPLOYMENT HISTORY

Start with most recent employer first.

EMPLOYER 1

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Position Held
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Salary:
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EMPLOYER 2

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EMPLOYER 3

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REFERENCE 1

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REFERENCE 2

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REFERENCE 3

Name:
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Phone
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CERTIFICATIONS AND ACKNOWLEDGEMENTS

Equal Employment Opportunity Statement
Sintergy, Inc. is committed to the principles of equal opportunity and is committed to make employment decision based on that merit. We are committed to complying with all Federal, State, and local laws providing for equal opportunities, as well as all laws related to terms and conditions of employment. Sintergy, Inc. desires to maintain a work environment that is free of sexual harassment and discrimination due to race, religion, color, national origin, physical or mental disability, age or any other status protected by Federal, State or local laws. Sintergy, Inc. will make reasonable efforts to accommodate those physical or mental limitations of an otherwise qualified employee unless undue hardship would result for the company.
Acknowledgement(*)
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Please type your initials to confirm that you have read and fully understand this statement.

Discrimination and Harassment Policy Statement
Sintergy, Inc. strictly prohibits and does not tolerate unlawful harassment against employees or applicants because of race, color, religion, national origin, sex, age, physical or mental disability or any other characteristic protected under applicable federal, state or local law. Any employee who engages in unlawful discrimination or sexual harassment will be subject to appropriate discipline, up to and including termination.
Acknowledgement(*)
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Disclosure to Applicants Concerning Drug Tests
If you are offered a position with Sintergy, Inc., you may be given a drug test as a condition of employment. Your refusal to timely submit to a drug test or your failure to pass such a test means you will not be employed by this company. Negative test results are required as a condition of employment.
Acknowledgement(*)
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Post-Hire Pre-Employment Testing
If offered a position with Sintergy, Inc., I understand that I may be asked to undergo legally permitted physical, psychological, skill, or medical tests as a condition of employment.
Acknowledgement(*)
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Background Investigation
I acknowledge that if I am offered employment with Sintergy, Inc., a job offer may also be contingent upon a background investigation which may include interviews with past employers, workers and friends. Said investigation may also include credit, driving, criminal background, references and other background checks.
Acknowledgement(*)
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At-Will Employment
I understand and agree that if I become employed by Sintergy, Inc., my employment will be “at-will”, which means that Sintergy, Inc. may terminate the employment relationship at any time, with or without cause and with or without notice. Likewise, Sintergy, Inc. will respect my right to terminate my employment at any time, with or without cause and with or without notice. This policy does not create a contract between Sintergy, Inc. and any person employed by Sintergy, Inc.
Acknowledgement(*)
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Company Obligation
I understand and agree that Sintergy, Inc.’s acceptance of this job application does not mean that a position for which I am qualified is open (unless specifically posted) or that Sintergy, Inc. has agreed to hire me. I understand that Sintergy, Inc. is under no obligation to hire me as the result of accepting this completed application.
Acknowledgement(*)
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Complete and Accurate Information
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission of information or falsification of this application, or any other document used to secure employment, shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
Acknowledgement(*)
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Upload Resume
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Signature (Typed)
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize Sintergy Inc. to make an investigation of all information contained in this employment application and I release from liability all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge. I specifically authorize and direct my current and former employers to supply employment-related information to this company and do hereby release my current and former employers from liability for providing information to this company. Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations. I hereby agree to submit to any drug test required, whether prior to my employment or if employed by this company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to my condition between the treatment provider and a company-designated physician. I further understand this is an application for employment and no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and the company may change wages, benefits, and conditions at any time. My employment is at will. No individual with the company is authorized to change the employment-at-will status except an officer of the company, who may do so only in writing. I have read and agree to the above.
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