Step 1 of 6 0% Please complete the employment application below if you are interested in employment at Ashland Telecom.Name(Required) First Middle Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Have you lived less than 5 years at current address?(Required) Yes No Previous Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneWork PhoneCell Phone(Required)FaxEmail(Required) Consent(Required) I understand that upon employment, proof of legal right to work in the United States and completion of I-9 form will be required.Are you eligible to work for any United States employer at this time?(Required) Yes No If you are under 18 years of age, do you have a work permit?(Required) Yes No Over 18 In the past 7 years, have you been convicted of a crime that has not been expunged by a court?(Required) Yes No Please explain(Required)*Note: Conviction of a crime Is not an automatic bar to employment.Can you travel if the position requires travel?(Required) Yes No If you have ever worked under or earned degrees under another name, please list below First Middle Last Position DesiredPosition Applied for(Required) How did you learn of this vacancy?(Required) Salary Desired (Annual) $(Required) Date Available (mm/dd/yyyy)(Required) Month Day Year Have you previously been employed by Ashland Telecom?(Required) Yes No Indicate position, department, and dates(Required)Do you have any relatives affiliated with Ashland Telecom?(Required) Yes No Who and how related?(Required)Ashland Telecom is an equal opportunity employer and recruits, advertises, employs, promotes, transfers, disciplines, and discharges without regard to race, color, religion, national origin, age, gender, marital status, ancestry, physical or mental disability, or veteran status. Education and Training Indicate Last Level of Education CompletedHigh School 1 year 2 year 3 year 4 year College or University 1 year 2 year 3 year 4 year Graduate School 1 Year 2 Year 3 Year 4 Year Education(Click the + button to add a new row)Type of EducationName, Location, and Phone NumberGPADid you graduate?Degree Earned Professional certifications and licenses (such as CPA, PHR, etc.)Computer skills (software programs, hardware, operating systems.)Other skills or experiences that are pertinent to the job applied for.(If you have had military service, and your duties were related to the position you are applying for and you want your experience to be considered, please list the duties) Employment History Must be completed even if you've mailed in your resume. List your last 3 employers with the most recent first.If you are currently employed, may we contact your employer?(Required) Yes No Employer(Required) Contact's Phone(Required)Starting Salary(Required) Ending Salary(Required) Dates Employed (MM/YYYY) to (MM/YYYY)(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name(Required) Supervisor’s Job Title(Required) Your Job Title(Required) Your Duties(Required)Reason for Leaving(Required)Add additional employment history?(Required) Yes No Employer(Required) Contact's Phone(Required)Starting Salary(Required) Ending Salary(Required) Dates Employed (MM/YYYY) to (MM/YYYY)(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name(Required) Supervisor’s Job Title(Required) Your Job Title(Required) Your Duties(Required)Reason for Leaving(Required)Add additional employment history?(Required) Yes No Employer(Required) Contact's Phone(Required)Starting Salary(Required) Ending Salary(Required) Dates Employed (MM/YYYY) to (MM/YYYY)(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Supervisor’s Name(Required) Supervisor’s Job Title(Required) Your Job Title(Required) Your Duties(Required)Reason for Leaving(Required) Professional References (Please list only references that we may contact at this time)Reference Name 1 First Last Title Company Home PhoneWork PhoneAdd second reference? Yes No Reference Name 2 First Last Title Company Home PhoneWork PhoneAdd third reference? Yes No Reference Name 3 First Last Title Company Home PhoneWork PhoneAdd fourth reference? Yes No Reference Name 4 First Last Title Company Home PhoneWork Phone Applicant Consent(Required) I hereby verify the above information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Nonbinding Application and Interview Process: I understand that this application will be reviewed, but nothing in this application or any other documents or in the employment evaluation process shall be construed as either an offer or contract of employment or an obligation on the part of Ashland Telecom to provide any benefit to me. Employment-At-Will: I understand that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either Ashland Telecom or myself. I hereby declare that my statements on this application and on my resume or documents provided by me to Ashland Telecom are true and correct to the best of my knowledge. I acknowledge and agree that providing any false information may result in a decision not to hire me, or if hired, may result in the termination of my employment. I also authorize investigation of these statements. This investigation may include employment history, reasons for leaving previous employers, criminal record, credit record, driving record, social security number investigation, and degree/certificate verification. I authorize the listed references and all of my previous employers to provide you with any and all applicable information they may have. I hereby release these references and previous employers from all liability for any information they may give you. I hereby release Ashland Telecom from all liability for any damages resulting from the information obtained. This application shall be considered active for a period of time not to exceed 180 days.Applicant Electronic Signature (Full Name)(Required)