Training and Evaluation
Center of Hutchinson
Hutchinson, Kansas
USA · 620 663-1596

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Application For Employment at TECH, Inc.


An Equal Opportunity Employer

Please complete this form online to apply for a position or select Print an Application, print the pdf file and return the completed form to TECH offices at:
   TECH, Inc.
   1300 East Avenue A
   PO Box 399
   Hutchinson, KS 67504-0399

- Tab between boxes -

Personal Information - Part 1 of 2
Date
Name   
First Name 		  
Middle Name
Last Name
Social Security Number 
Home Phone
Cell Phone
Home Address   
Street 		  
City 		  
State
Zip Code
Mailing Address
   
Street 		  
City 		  
State
Zip Code
 
Are you 18 years old or older?   Yes   No  
Do you have a current drivers license?   Yes   No
Are you prevented from lawfully becoming employed in this country because of VISA or immigration status?   Yes   No
Have you ever been convicted of a Felony (if so, explain below)?   Yes   No
        
 
Position desired  
Start date  
Salary desired  
Are you employed now?   Yes   No
If so, may we inquire of your current employer?   Yes   No
Have you ever applied at TECH before?   Yes   No
When  
Have you ever worked at TECH before?   Yes   No
When  
Title  
Supervisor  
 
Referred by  

Education
High School Name   
  Graduate?   Yes   No
  Subjects   
 
College Name   
  Graduate?   Yes   No
  Subjects   
 
Trade or Business School Name   
  Graduate?   Yes   No
  Subjects   
 
Special Skills       

 

U.S. Military or Naval Service   
Rank   
Presently in National Guard or Reserves?   Yes   No

Former Employers

List below last three employers, starting with the most recent one first.
Please include current employer if you are currently employed.
1 - Most Recent
Dates   From
  To
      Name, Address, Phone & FAX Number of Employer
    
Supervisor   
Position   
Reason for leaving   
May we contact?   Yes   No
Salary   
      Position Responsibilities
    
 
 
2
Dates   From
  To
      Name, Address, Phone & FAX Number of Employer
    
Supervisor   
Position   
Reason for leaving   
May we contact?   Yes   No
Salary   
      Position Responsibilities
    
 
 
3
Dates   From
  To
      Name, Address, Phone & FAX Number of Employer
    
Supervisor   
Position   
Reason for leaving   
May we contact?   Yes   No
Salary   
      Position Responsibilities
    
 
 

References


Give the name of 3 persons not related to you whom you have known for at least 1 year.
1 Name   
Phone Number   
Occupation   
Years Acquainted   
 
2 Name   
Phone Number   
Occupation   
Years Acquainted   
 
3 Name   
Phone Number   
Occupation   
Years Acquainted