Personal Information * First Name: Middle Name: * Last Name: * Address: * City: * State: * Zip Code: * Email Address: * Home Phone: Cell Phone: * In the past 10 years, have you been convicted of a misdemeanor or felony? Conviction is not necessarily a bar to employment. Yes No * If yes, please explain: * Have you worked for Summit Aviation in the past?Yes No * If yes, please provide dates and position held: * Only U.S. citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, after employment, submit verification of your legal right to work in the U.S.? Yes No Employment Interests/Skills * Position for which you are applying: * Salary Requirement: * Date available for work (mm/dd/yyyy): * Referral Source:---Employee ReferralState Workforce AgencyCompany WebsiteEmployment AgencyAdvertisementInternetLinkedInIDOLVeterans AdministrationCollege/Trade SchoolStatesmanCareerBuilderMonsterRadioCraigslistBronco JobsOther Referred By: Airframe Knowledge: Education * High School (Name & Location): * Last Grade / Level Completed: * Diploma:Yes No College, Business, Vocational: Last Level Completed: Diploma/Degree: Course/Major: Other Training (use as much space as needed): Motor Vehicle Driver Applicants–Complete * Do you have or can you obtain a valid driver's license? Only if required by position. Yes No Employment History Please provide employment information beginning with current or most recent employer. Account for all time periods including unemployment, self-employment and U.S. Military Service. Please provide all the requested information for each job as space permits. * Employer Name, City and State: * Job Title: Start Date of Employment (mm/yyyy): End Date of Employment (mm/yyyy): Starting Salary: Ending Salary: Duties and Responsibilities: Reason for Leaving: * May we contact this employer?Yes No * Phone: Please provide employment information beginning with current or most recent employer. Account for all time periods including unemployment, self-employment and U.S. Military Service. Please provide all the requested information for each job as space permits. Employer Name, City and State: Job Title: Start Date of Employment (mm/yyyy): End Date of Employment (mm/yyyy): Starting Salary: Ending Salary: Duties and Responsibilities: Reason for Leaving: May we contact this employer?Yes No Phone: Please provide employment information beginning with current or most recent employer. Account for all time periods including unemployment, self-employment and U.S. Military Service. Please provide all the requested information for each job as space permits. Employer Name, City and State: Job Title: Start Date of Employment (mm/yyyy): End Date of Employment (mm/yyyy): Starting Salary: Ending Salary: Duties and Responsibilities: Reason for Leaving: May we contact this employer?Yes No Phone: References Name: Company: Phone: Years Known: 1. 2. 3. Attach Resume Click "Browse" to select your resume file Statement Certification I certify that the statements made in this application are true and correct and understand that falsification of such statements and information is grounds for immediate dismissal in accordance with Summit Aviation policy. In consideration of my employment, I agree to conform to the rules and regulations of Summit Aviation and realize that my employment and compensation can be terminated at any time, with or without notice, by the Company or myself. I understand that no Summit Aviation representative has the authority to enter into any other agreement with me for employment for any specified period of time or to make any agreement contrary to the foregoing statement. I understand that employment may be contingent upon passing a motor vehicle records check and a security background check if included in the position requirements. I agree to authorize Summit Aviation to verify statements made in this application, and authorize all previous employers or other persons having knowledge of myself or my record to release such information to Summit Aviation. I hereby release those companies and persons and Summit Aviation from all claims and liabilities that may arise by such disclosures or such investigation. I agree with statement. Notice to Applicants - Drug Free Workplace Summit Aviation has a Drug Free Workplace Policy which strictly prohibits the use, purchase, sale or distribution of illegal drugs (meaning those drugs for which there is no generally accepted medical use, e.g., marijuana, cocaine, opiates, phencyclidine (PCP), amphetamines, or a metabolite of those drugs), drug paraphernalia, or use of alcohol by an employee in company vehicle, at a job site, on company property, without company approval, or during work hours. A requirement for consideration of employment with Summit Aviation is the passing of a pre-employment test for the presence of illegal drugs. Any prospective employee who tests positive for the presence of illegal drugs will not be offered employment with the company. Applicants who become employees of Summit Aviation will be required to comply with the company’s Drug Free Workplace Policy which also includes random, reasonable cause, reasonable suspicion and post-accident testing. I understand this policy. Voluntary Affirmative Action Information Summit Aviation is an Equal Opportunity Employer. We consider applicants for all positions without regard to sex, race, color, religion, national origin, age, veteran’s status, disability, or any other legally protected status.We request your cooperation in providing the following information which will be used in accordance with federal and state statutes and regulations regarding Equal Employment Opportunity and Affirmative Action. Providing this information is voluntary. All information received remains separate from your employment application and is not used in any way during the interviewing and hiring process.If you choose not to provide this information, check the box below indicating your decision. The absence of this data will, however, limit our effectiveness in auditing our employment practices and meeting fair employment reporting requirements. Decline to Answer Male Female Protected Veteran Not a Protected Veteran Do Not Wish to Identify Race and Ethnic Identification: Please indicate your ethnicity or race by selecting an option below. If you are Hispanic/Latino, please select the Hispanic category. If you are not Hispanic/Latino, please select one of the other categories. (Check One): Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture of origin regardless of race. White (not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa. Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine islands, Thailand and Vietnam. American Indian or Alaskan Native (not Hispanic or Latino): A person having origins in any of the original peoples of North America and South American (including Central America), and who maintain tribal affiliation or community attachment. Two or More Races (Not Hispanic or Latino): A person who identifies with more than one of the above five races. Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to hire and provide equal opportunity to qualified perople with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier. How do I know f I have a disability? You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Please select on eof the boxes below: Yes, I have a disability No, I don't have a disability I don't wish to answer Reasonable Accomodation Notice Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.