About Us

Employment Application

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Employment Application Form

Please fill out, read the notices, and click submit at bottom.

Referred by :
Job Position you are applying for:

PERSONAL INFORMATION

* Telephone No. Residence:

Cell No:
* Email:
* First Name
M.I.
* Last Name
Do you have reliable transportation? Do you possess a valid driver's license?
Present Address:
* Street No.
* City
* State
* Zip Code
Previous Address:
Street No.
City
State
Zip Code
Permanent Address:
Street No.
City
State
Zip Code
EMPLOYMENT DESIRED
Date you will be available for work
Salary Desired $
Are you currently employed?
If so, may we contact your employer?
If you have applied to this company before,

please indicate when and position.

Do you have any relatives employed by this company?
If so, please list names.
If you have worked for this company before,

please indicate when and position held.

* Do you seek full- or part-time employment?
List other names or aliases you have

used.

* If employed, can you provide proof of legal right to

work in the United States?

If no, please explain.
* Have you ever been convicted of a felony or are you on

bail pending trial for a felony?

If yes, please explain in full with

description of the case.

Skills, abilities, qualifications, or

experiences which you feel would fit you to work for

Atkinson Baker:

Do you type?
If yes, how many WPM?
* Do you have or anticipate any obligations which could

conflict with a standard work schedule or performance of

assigned duties?

If yes, describe.
EDUCATION HISTORY
Languages Spoken:
Last Elementary School Attended:
Name: City: State: Grade Completed:
Last High School Attended:
Name: City: State: Grade Completed:
Junior College Attended:
Name: City: State: Year Completed:

Major:
Minor:
College or University Attended:
Name: City: State: Year Completed:
Major:
Minor:
Graduate School Attended:
Name: City: State: Year Completed:
Major:
Minor:
Trade School Attended:
Name: City: State: Year Completed:
Major:
Minor:
Adult Education or Special Training:
PROFESSIONAL REFERENCES
Please list three professional references

you have known for at least one year:

1. Name
Address
Telephone
Relationship
Years Known
2. Name
Address
Telephone
Relationship
Years Known
3. Name
Address
Telephone
Relationship
Years Known
In case of emergency, who should we notify?
* Name
Address
City
State
Zip Code
* Telephone
* Relationship
EMPLOYMENT HISTORY
List your present or last position.
* Company Name
Address
* Phone
Name/Title of Supervisor
* Job Title
* Ending Pay
* Dates of Employment (Month/Year) from
* to
* Type of work performed
* Reason for Leaving


List your previous position.
Company Name
Address
Phone
Name/Title of Supervisor
Job Title
Ending Pay
Dates of Employment (Month/Year) from
to
Type of work performed
Reason for Leaving


List your previous position.
Company Name
Address
Phone
Name/Title of Supervisor
Job Title
Ending Pay
Dates of Employment (Month/Year) from
to
Type of work performed
Reason for Leaving


Please explain any gap in employment

history above.

Please explain any work-related

accomplishments you are especially proud of.

Hobbies, recreation, Special Interests:
Have you ever been granted a security

clearance?

If yes, Date
Level
Today's Date:
READ STATEMENTS BELOW CAREFULLY BEFORE

AGREEING

I certify that the answers given herein are true and

complete to the best of my knowledge. I agree that any

misrepresentation, false statement, or omission made by me

with respect to the information contained in this

application or interview(s) shall be sufficient cause to

disqualify me from consideration or, if hired, to terminate

my employment.

I agree to have any of the statements herein as well as my

background investigated by Atkinson-Baker, Inc., or its

agents. I understand that the background investigation may

include, but is not limited to, reviewing my education,

employment history, credit history, any public records, and

personal references. In consideration for reviewing my

application and other related information, I hereby waive

and release Atkinson-Baker, Inc., its employees and agents,

and all other entities and persons, and their respective

employees and agents, from any claims I might have,

including defamation and invasion of privacy, arising out of

any verbal or written inquiries and/or any verbal or written

responses related to investigation of my background as well

as the use or disclosure of such information.

I acknowledge and agree that in order to enable the Company

to determine whether I possess the skills and other personal

qualities necessary to qualify for the position I am

applying for, the Company may engage in a testing and

interview process which includes reading a full job

description. The tests may include but not be limited to

those that measure intelligence, aptitude, and personality

traits required to meet the requirements of the position,

including but not limited to meeting the Company's standards

for performance, interpersonal relations, and competence on

the job. Accordingly, I hereby release the Company

(Atkinson-Baker, Inc., and Master Tech) and any and all

Company officers, stock holders, employees, representatives,

agents, licensees, licensors, subsidiaries, parent

corporations associated with testing services and any and

all other related individuals, corporations, partnerships

and organization from any and all claims, demands, suits

and/or liabilities -- including but not limited to claims

based on any state or federal rights of privacy -- arising

from or in any way related to such testing and interview

processes.

I understand that nothing contained in this pre-employment

application or in the granting of an interview is intended

to create an employment agreement. I also understand that

the completion of this pre-employment application does not

indicate there are open positions and does not obligate

Atkinson-Baker, Inc., in any way.

I agree that, if employed, I will abide by all policies and

procedures established by Atkinson-Baker, Inc. I understand

that my employment is "at will," that I may resign at any

time, that Atkinson-Baker, Inc., may terminate my employment

at any time, with or without cause, and that no employee or

other representative of Atkinson-Baker, Inc., has the

authority to make an agreement contrary to the foregoing

unless it is in writing AND signed by the CEO of Atkinson-

Baker, Inc. This constitutes my entire agreement with

Atkinson-Baker, Inc., with regard to the matters set forth

in this paragraph.

I further recognize that employment is subject to:

* Receiving satisfactory reports from all references

solicited.
* Approval of the management of Atkinson-Baker, Inc., in

which employment may be offered.

I also recognize that I will be required to:

* Supply a record of birth, U.S. citizenship, or visa

status, as appropriate.
* Sign statements dealing with our policy on Conflict of

Interest, Confidential Information, Drugs, Harassment, and

certain other employment forms.

It is understood that if, after I have submitted this

application to Atkinson-Baker, Inc., any changes occur which

affect the accuracy of the information entered herein, it

shall be my responsibility to inform Atkinson-Baker, Inc. of

such changes prior to accepting employment.

Thank you for expressing an interest in working for our

company. As you may know, our company operates in accordance

with principals of "Management by Statistics" and other

management tools, developed by L. Ron Hubbard, American

author, philosopher and founder of the Scientology religion.

While Mr. Hubbard developed this system of management for

use by the Churches of Scientology, it is non-religious and

proven to be equally applicable in the everyday business

environment. It is currently utilized successfully by

businesses worldwide. Accordingly, if your application is

accepted for further consideration, prior to entering into

an employment agreement, you will have the opportunity to

familiarize yourself with the basics of our management

system to ensure that you feel you could be comfortable and

productive in working with us.

|| PLEASE PRESS SUBMIT ONCE ||

The form will be processed and sent within a few moments.

You will then be
re-directed to a new page confirming your application has

been received.