We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed

service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information, pregnancy, citizenship status or any other category protected by applicable federal, state, or local laws.

The Company is an at will employer where allowed by applicable state law; this means that regardless of any provision in this

application, if hired, the Company or applicant, may terminate the employment relationship at any time, for any lawful reason, with

or without cause or notice. This application does not create any type of express or implied contract.

NOTICE TO APPLICANTS: SCREENING TESTS FOR ILLEGAL DRUG USE WILL BE REQUIRED AS A CONDITION OF EMPLOYMENT.

Please Answer All Questions. Resumes Are Not A Substitute For A Completed Application.

Desired Position *

Please choose from the dropdown.

Referral Source *

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Employee
Relative
Walk-In
Government Employment Agency
Private Employment Agency
Other

Please List Referral *

First Name *

Last Name *

Address *

Current Street, City and State Address

Email *

Phone *

Best Time to Call *

AM/PM *

Please Attach Your Resume and Cover Letter

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Supported format: PDF, DOC, DOCX

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Please Answer All Questions. Resumes Are Not A Substitute For A Completed Application.

If you are under 18 and it is required, can you furnish a work permit? *

If no, please explain *

If hired, are you able to provide documentation that you are authorized to work in the United States? *

If not, what steps must be taken for you to begin employment lawfully? *

Have you submitted an application here before? *

If yes, give dates and positions *

Have you been employed by Ioxus before? *

If yes, give dates: *

Reason for separation:

Type of employment desired: *

Full Time
Part Time
Temporary

Are you willing to work overtime if necessary? *

Date available to begin employment: *

Desired salary range: *

Do you have any commitments to any other employer which could affect your employment with this Company if hired (for example, an employment agreement, a non-competition or non-solicitation agreement, etc.)? *

Have you ever been bonded? *

Do you have a valid driver’s license? *

Employment History

Please list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. Attach additional sheets if needed. If self-employed, provide firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Please do not answer “see resume.”

Employer Name: *

Currently Employed: *

Employer Telephone Number: *

Please include area code

Dates Employed *

Employer State, City & State Address: *

Starting Job Title: *

Supervisor Name, Title & Phone Number: *

Final Job Title: *

Supervisor Name, Title & Phone Number: *

Summarize Work Performed and Responsibilities: *

Reason for Leaving: *

May We Contact for Reference? *

Yes
No
Later

If No, please provide explanation: *

Would You Like To Add Additional Employment History? *

Employment History #2

Employer Name: *

Currently Employed: *

Employer Telephone Number: *

Please include area code

Dates Employed *

Employer State, City & State Address: *

Starting Job Title: *

Supervisor Name, Title & Phone Number: *

Final Job Title: *

Supervisor Name, Title & Phone Number: *

Summarize Work Performed and Responsibilities: *

Reason for Leaving: *

May We Contact for Reference? *

Yes
No
Later

If No, please provide explanation: *

Would You Like To Add Additional Employment History? *

Employment History #3

Employer Name: *

Currently Employed: *

Employer Telephone Number: *

Please include area code

Dates Employed *

Employer State, City & State Address: *

Starting Job Title: *

Supervisor Name, Title & Phone Number: *

Final Job Title: *

Supervisor Name, Title & Phone Number: *

Summarize Work Performed and Responsibilities: *

Reason for Leaving: *

May We Contact for Reference? *

Yes
No
Later

If No, please provide explanation: *

Please explain any gaps in employment history. *

Have you ever been terminated or asked to resign? *

Have you ever been given the choice to resign rather than be terminated? *

If you answered Yes, please explain the circumstances of each occurrence. *

Skills and Qualifications

Describe your qualifications and summarize any special training.

List any professional or occupational registrations, licensure or certifications

References

Please complete below requesting additional business/work references (not listed above or relatives) that have worked with you. Individuals without work experience may list school or volunteer references.

Name

Phone

Position

Company

Work Relationship

Years Known

Name

Phone

Position

Company

Work Relationship

Years Known

Name

Phone

Position

Company

Work Relationship

Years Known

Please complete the table below requesting personal references (not previous employers or relatives) that we may contact.

Name

Phone

Occupation

Relationship

Years Known

Name

Phone

Occupation

Relationship

Years Known

Name

Phone

Occupation

Relationship

Years Known

Additional Information

List professional, trade, business or civic associations and any offices held. Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve national guard or any other similarly protected status.

Organization

Office Held

Organization

Office Held

Organization

Office Held

List special accomplishments, publications, awards, etc.

Provide any additional information you would like us to consider.

Applicant Certification

I understand that the Company has a drug-free workplace of drug and/or alcohol testing program consistent with applicable federal, state, and local law. If I am offered a conditional offer of employment, I understand that if a pre-employment (post-

offer) unlawful drug and/or alcohol test is positive, the employment offer may be withdrawn where allowed by law. I agree towork under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law, may be

subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that alcohol and/or drug testing may be a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company’s policies and applicable federal, state, and local laws.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, I will be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement.

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver’s license and automobile liability insurance in an amount equal to the minimum required by the state where I reside.

If hired, I agree to conform to the lawful rules and regulations of the Company, and I understand the Company has complete discretion to modify such rules and regulations at any time.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state and local law, may exercise its right, without prior warning or notice, to conduct investigations of Company property (including, but not limited

to files, lockers, desks, vehicles, phones and computers) and in certain circumstances, my personal property. I understand that I have no expectation of privacy in Company property.

I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete and accurate, to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.

I authorize the Company and/or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking, to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization

forms for background investigations which may be permitted by federal, state, and/or local law.

I authorize and consent to, without reservation, any party or agency contacted by this employer (including any and all prior employers of mine) to furnish information regarding my previous employment history and/or any of the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the Company to provide truthful

information concerning my employment to future employers and hold the Company harmless for providing such information.

If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals

who are legally eligible to work in the United States.

This application will be considered active for a maximum of sixty (60) days. If you wish to be considered for employment after

that time, you must reapply.

DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLICATION.

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE.

I ACCEPT ALL THE TERMS OF THE FOREGOING APPLICANT STATEMENT. *

Applicant Name *

Date *

Thanks for your application.

We appreciate you applying to work with Ioxus. One of our team members will get back in touch if we would like to move forward!

Have a great day!

Thanks for your application.

We appreciate you applying to work with Ioxus. One of our team members will get back in touch if we would like to move forward!

Have a great day!

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