Employment Application

Please include all information requested. Application will not be accepted without applicant acknowledgement.

All applicants are subject to a drug screening prior to employment.

By applying, you agree to all terms and conditions of Tri-Logic’s Employment Application Waiver.

First Name

Last Name

Current Address

How Long Have You Lived at This Address?

Primary Phone Number

Secondary Phone Number (optional)

Email (optional)

Date of Birth

Position You Are Applying For?

Desired Salary or Hourly Pay

How Many Hours Can You Work Weekly

Are You Able To Work Nights

Are You Able To Be On Call?

Type of Employment Desired

When Are You Available To Start Work?

Have You Ever Been Convicted of a Crime?

If Yes, Explain the Number of Convictions, Nature of the Offenses Leading to the Convictions, How Recently the Offenses Were Committed, the Sentence Imposed and Type of Rehabilitation.

Have You Served in the Armed Forced?

Are You a Member of the National Guard?

If Yes to Either of the Two Questions Above, What Was Your Specialty, Date Entered, and Discharge Date?

Do You Have A Driver License?

Type of License

Have You Had Any Accidents in the Last 3 Years?

Have You Had Any Moving Violations in the Last 3 Years?

Do You Have Reliable Transportation To and From WorK?

Please List Two References Other Than Relatives or Previous Employers Including Their Contact Information

Highest Level Of Education Attained

Major and Degree Type

Please List Your Work Experience for the Past 5 Years Beginning With Your Most Recent Employer. If You Were Self Employed, List the Firm Or Company in Which You Worked Under:

Or You Can Upload Your Most Recent Resume With Work Experience

Can We Contact Your Previous Employers?

Please Acknowledge

This Application is Not a Contract of Employment. Signing and Submitting This Application Does Not Bind You to Employment with Tri-Logic Nor Does it Guarantee Employment with Tri-Logic or Any of it's Subsidiaries. If You Agree with the Terms of This Application, Please Sign Your Name and Date the Application

Full Name

Today's Date

Employment Application

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