JOB APPLICATION

PERSONAL INFO

First Name:*

Middle Name:

Last Name:*

Phone Number:*

Email Address:*

CURRENT ADDRESS

Street:*

City:*

State:*

Zip Code:*

Since (Mo/Yr):*

PRIOR ADDRESS (1)

Street:

City

State:

Zip Code:

Since (Mo/Yr):

PRIOR ADDRESS (2)

Street:

City

State:

Zip Code:

Since (Mo/Yr):

EDUCATION

High School

School:

City:

State:

Diploma Yes No

Undergrad School

School:

City:

State:

Diploma: Yes No

Type of Degree/Area of Study:

Graduate School

School:

City:

State:

Diploma: Yes No

Type of Degree/Area of Study:

Other School

School:

City:

State:

Diploma/Certificate: Yes No

Type of Degree/Certifcate:

EMPLOYERS

May we contact your present employer? Yes No

Most Recent Employer

Employer:

City:

State:

Zip Code:

Phone:

Postion Held:

From (Month/Year)

To (Month/Year)

Pay upon leaving:

Supervisor:

Duties:

Reason For Leaving:

Prior Employer (1)

Employer:

City:

State:

Zip Code:

Phone:

Postion Held:

From (Month/Year)

To (Month/Year)

Pay upon leaving:

Supervisor:

Duties:

Reason For Leaving:

Prior Employer (2)

Employer:

City:

State:

Zip Code:

Phone:

Postion Held:

From (Month/Year)

To (Month/Year)

Pay upon leaving:

Supervisor:

Duties:

Reason For Leaving:

REFERENCES

List three people (no relatives) that you have worked for or with, that we may use as a reference.

Reference 1

Name & Company Name:*

Phone:*

Relationship (Supervicor/Co-worker/Other):*

Reference 2

Name & Company Name:*

Phone:*

Relationship (Supervicor/Co-worker/Other):*

Reference 3

Name & Company Name:*

Phone:*

Relationship (Supervicor/Co-worker/Other):*

RESUMES

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AGREEMENT

IMPORTANT- We are glad you are interested in joining Lectrosonics. Please read the following statement carefully before you sign and return this application. Lectrosonics, in considering my application for employment, may verify the information set forth on this application and obtain additional background information relating to my background. I authorize all persons, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any information concerning my background. I have read, understand and agree to this statement.
I certify that the information on this application is correct and I understand that any misrepresentation or omission of any information will result in my disqualification from consideration for employment or, if employed, my dismissal. I understand that this application is not a contract, offer, or promise of employment and that if hired I will be able to resign at any time for any reason. Likewise, the company can terminate my employment at any time with or without cause, unless otherwise required by law. I further understand that no one other than the President of Lectrosonics, or Vice President has the authority to enter into an employment contract or agreement with me, and that my at-will employment can be changed only by a written agreement signed by the President of Lectrosonics. I have read, understand and agree to this statement.
Should I be employed by Lectrosonics I hereby agree, in consideration of that employment, that all inventions, improvements, ideas, computer programs, applications of software (hereinafter ideas) I conceive, make, reduce to practice, along or in combination with others, during my period of employment by Lectrosonics and for a reasonable time thereafter, whether during or outside working hours, which relate to the business of Lectrosonics or result from tasks assigned to me by Lectrosonics, shall be the property of Lectrosonics, and that I will make full and timely disclosure of all such items to Lectrosonics and in a form prescribed by Lectrosonics, and assist Lectrosonics at any time during and subsequent employment by it, in every lawful, proper and reasonable manner, to obtain, maintain and enforce patents, copyrights and intellectual property rights on said items, including the execution and assignment of all documents necessary thereto. I further agree to keep confidential and not use or divulge, unless authorized to do so by the company, all confidential information and trade secrets of Lectrosonics I obtain or become aware of as a result of my employment.
I understand that this application is good only for six (6) months from today’s date. If I still desire a position with the company after this application expires, it will be my responsibility to fill out a new application and file it with the company. Otherwise, the company will not consider me for employment after this application expires.
I certify that the information on this application is correct and I understand that any misrepresentation or omission of any information will result in my disqualification from consideration for employment or, if employed, my dismissal. I understand that this application is not a contract, offer, or promise of employment and that if hired, I will be able to resign at any time for any reason. Likewise, the company can terminate my employment at any time with or without cause.
I understand that by signing my name in the signature box below and submitting this application electronically, this becomes a legal and binding contract.

SIGNATURE

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Thank you for your interest in Employment with Lectrosonics

Your application and/or resume has been received and will be reviewed and considered for open positions that apply to your qualifications. This is the only response you will receive unless contacted for an interview.

We request that you do not call us. Thank You

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