COMPLETE ALL FIELDS - Following formatting guidelines for phone number, dates, etc. State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Different mailing address than above? State (if different)AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming EMPLOYMENT DESIRED Applying for Seasonal/Temp or Full Time? *Full TimePart TimeTemporary If hired, when can you start? *ImmediateOne WeekTwo WeeksThree WeeksFour WeeksLonger PERSONAL INFORMATION Have you ever applied to or worked for Geotech? YesNo Do you have friends/ relatives working for Geotech? YesNo Can you show legal right to live and work in the United States? YesNo Have you ever been convicted of a crime, including misdemeanors? (*A conviction will not necessarily disqualify you) YesNo Are you on parole? YesNo EDUCATION, TRAINING AND EXPERIENCE include name and location of school or college Graduated? YesNo Years Completed123456789101112 Graduated? YesNo Years Completed123456789101112 Graduated? YesNo Years Completed123456789101112 Check if you speak, write or understand any foreign (non English) language? YesNo COMPLETE THIS SECTION IF APPLYING FOR A DRIVING POSITION Do you have a Valid Texas Driving License? YesNo Are you 21 years or older? YesNo State where it was issuedTexasAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Has your license ever been revoked/suspended? YesNo Are you licensed/certified for ACI or NICET? YesNo EMPLOYMENT HISTORY Present and past employment starting with most recent employer. Employer 01 StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Pay periodWeeklyEvery two weeksTwice a MonthMonthly Employer 02 StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Pay periodWeeklyEvery two weeksTwice a MonthMonthly Employer 03 StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Pay periodWeeklyEvery two weeksTwice a MonthMonthly Employer 04 StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Pay periodWeeklyEvery two weeksTwice a MonthMonthly PROFESSIONAL REFERENCES (No relatives or friends) Reference 01 Reference 02 Reference 03 Reference 04 Reference 05 Resume IMPORTANT NOTICE: APPLICANT MUST COMPLETELY ANSWER EACH QUESTION OR THIS APPLICATION WILL NOT BE PROCESSED FURTHER I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also understand that a criminal background check will be conducted. I understand that any intentional misrepresentation or material omission made by me on this application may constitute grounds for cessation of job offer or immediate termination of employment if I am employed, without notice, whenever it may be discovered. I further certify that I, the undersigned applicant, personally completed this application. I understand that any omission or misstatement of fact on this application or any document used to secure employment shall be grounds for rejection of this application or immediate discharge if I am employed; regardless of the time lapsed before discovery. I understand that nothing contained in the application or conveyed during any interview, which may be granted, is intended to create an employment contract between the company and me. I understand that this application is not an offer of employment and no promises or representations of employment have been made to me at this time. I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative. If hired, I will be responsible for familiarizing myself with all rules, regulations, policies, procedures and regulations of the Company as they presently exist or are later modified. I understand that this is a drug-free workplace and consent to compliance with this policy as condition of employment. This application is valid for only ninety (90) days from the date submitted. If I want to be considered for job openings more than ninety (90) days from the submittal date, I will be required to submit a new application. This company is a Drug Free Workplace and I understand that a Drug Test will be required. I have read, understand, and agree with the above. If you application does not go through, scroll up and check that all required fields have been correctly completed) (*Note: No applicant will be denied employment soley on the grounds of conviction of a crime offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offens to the position(s) applied for may, however, be considered.)