Integrity Testing & Inspection 

 

3861 Vincent Station Drive
Owensboro, KY 42303

(270) 689-9980

 

6410 Airport Road Suite D/E
El Paso, TX 79925

(915) 772-1800

 

OFFICE HOURS:
8am-5pm M-F 

 

After Hours/Emergency Contact

(270) 689-9980

 

 

 

 

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Please fill out the form below and then look in your inbox for a copy of the below information.

Date:
Position Applying for:
Referral Source:
Full Name:
Maiden Name (if applicable):
Home Address:
City / State / Zip:
Email:
Home Phone:
Cellular Phone:
If Under 18, can you provide a work permit?
Have you ever filed an application here before?
Application Date:
Have you ever been employed here before?
Employment date:
Are you currently employed?
If yes, list employer:
If yes, may we contact your employer?
If yes, list information:
Are you a United States citizen?
If no, do you have a valid work permit?
Employment Desired:
When are you available to start work?
Are you on a lay-off and subject to recall?

Can you travel if a job requires it?
Pay Expected:

Sealed Record Notice:

A criminal background check will be performed as a condition of employment.

Applicants having sealed conviction records on file with the Commission of Probation may answer "no" to the following:
Within the past five years, have you been convicted of a misdemeanor? (Applicants may answer "no" with respect ot a first conviction for drunkenness, simple assault, minor traffic violations, affray or disturbance of the peace).

If yes, please explain
Have you ever been convicted of a felony?

Education
Type of School Name of School Location (City, State) Number of Years Completed Major & Degree
High School

College
Graduate School
Business or Trade School
Professional School

Other Special Skills:

Driver's License:

Most positions require a valid driver's license.
Do you have a valid driver's license?  
Driver's license number:  
State of issue:
Expiration Date:  
Date of Birth:  
Have you had any accidents during the past three years? How Many?
Have you had any moving violations in the past three years? How Many?

Military:
Are you a veteran of the United States military service?  
If yes, what branch?  
If yes, Date Entered:  
Date Discharged:  
If yes, please describe any special skills or training acquired while in the service:

Work Experience:

Please list your paid or unpaid work experience for the last 15 years beginning with your most current or the most recent job.  If you were self-employed, give firm name.  Explain significant breaks in your work experience.  Attach additional sheets if necessary.  Describe each job separately, emphasizing your specific duties and responsibilities including management, supervisory, or leadership roles.  Exclude organization names which indicate race, color, creed, national origin, age, religion, sexual orientation, gender identity, gender expression, veteran status, or disability.

Most Recent Employer
Dates Employed: From: To:
Address: Phone:
Job Title: Did you work full time?
Supervisor: May we contact employer?
Reason for leaving:    
Work Performed:

Employer
Dates Employed: From: To:
Address: Phone:
Job Title: Did you work full time?
Supervisor: May we contact employer?
Reason for leaving:    
Work Performed:

Employer
Dates Employed: From: To:
Address: Phone:
Job Title: Did you work full time?
Supervisor: May we contact employer?
Reason for leaving:    
Work Performed:

Employer
Dates Employed: From: To:
Address: Phone:
Job Title: Did you work full time?
Supervisor: May we contact employer?
Reason for leaving:    
Work Performed:

Non-Discrimination Policy:

Integrity Testing & Inspection, Inc. is committed to the principle of equal opportunity in education and employment.  Therefore, Integrity Testing & Inspection, Inc. does not discriminate on the basis of sex, race, color, creed, national origin, age, religion, sexual orientation, gender identity, gender expression, veteran status, or disability in admission to, access to, treatment in, or employment in its programs and activities.

References:

  

Please list at least three professional or personal references, who can speak about your work history, quality of work, and attendance.  This is a formality and an important part of the interview process.  You may send Letters of Recommendation to Stacy Watts - swatts@itilabs.com

Reference 1

      
Name and Position Email Address:
Telephone Number Work Relationship:
Company: Address and Number

Reference 2

      
Name and Position Email Address:
Telephone Number Work Relationship:
Company: Address and Number

Reference 3

      
Name and Position Email Address:
Telephone Number Work Relationship:
Company: Address and Number

Reference 1

      
Name and Position Email Address:
Telephone Number Work Relationship:
Company: Address and Number

WAIVERS AND DISCLOSURES:

Please read each section carefully and sign where indicated.

AT-WILL EMPLOYMENT:

It is my understanding that this employment application, or the granting of an oral interview, does not represent a contract of employment or a promise of future benefits by this organization.  I understand and agree that, if hired; my employment will be at-will in nature and may be terminated, with or without cause, at any time, by either myself or my employer.  I also understand that this written statement supersedes any and all oral representations made by agents or representatives of this organization.

CERTIFICATION OF TRUTH AND ACCURACY:  

I certify that the information in this application is true, complete and correct. I understand that false answers, statements, or significant omissions made by me on this form shall be sufficient cause for denial of employment or discharge.

NOTIFICATION AND AUTHORIZATION TO REQUIRE A MEDICAL EXAMINATION:  

I hereby certify that, if hired, I will disclose any limitations I have that may impact my ability to do the job.  I understand that I will be required to undergo a pre-employment and random drug and alcohol screens.

NOTIFICATION AND AUTHORIZATION TO CONDUCT BACKGROUND INVESTIGATION:  

I understand that I may be subject to a background check, and hereby authorize Integrity Testing & Inspection, Inc., to investigate my background to determine any and all information of concern as to my record, whether same is of record or not, and I release employers and persons named in my application from all liability for any damages on account of his/her furnishing said information.  Additionally, you are hereby authorized to make any investigation of my personal history, educational background, military record, motor vehicle records, and criminal records and/or credit history through an investigative or credit agency or bureau of your choice.  I authorize the release of this information by the appropriate agencies to the investigating service.  This authorization, in original or copy form, shall be valid for this and for any future reports and updates that may be required.  I understand that passing the background check is a condition of employment.  A negative background check can be grounds for dismissal, even if an offer has been made to me and I have been hired.
E-Signature Date:


Thank you for applying to Integrity Testing & Inspection, Inc.
3861 Vincent Station Drive, Owensboro, KY 42303

Telephone:  270-689-9980    
swatts@itilabs.com         

Fax:  270-689-9660
www.itilabs.com