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Lao Democratic Republic
Papua New Guinea
Saint Vincent Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
Social Security Number:
Are you 18 or older?:
Driver's License No.:
How did you hear about us?
Other (Please Specify)
Other (Specify Source):
I am authorized to work in this country for any employer
I am authorized to work in this country for my present employer only
I require sponsorship to work in this country
My status to work in this country is unknown
Highest Education Level:
High School Diploma / GED
Trade or Technical School Diploma
Have you worked for Athlon Solutions LLC or any of its subsidiaries or affiliates before?
Work for Athlon before?:
If yes, when:
Rate of Pay:
Do you have any relatives currently working at Athlon?
Relatives working here:
If yes, please provide the name(s) and relationship.
Names and relationship:
When available to work:
Are you willing and available to work overtime as necessary?
Willing to work overtime:
Can you travel if the job requires it?
Can you travel:
Ever been bonded:
Name of bonding company:
Are you able to perform the essential functions of the position for which you are applying, with or without reasonable accommondation?
If no, please explain:
Have you ever plead guilty or been convicted of a felony or misdemeanor, including driving under the influence of intoxicants? (Ohio and Oklahoma applicants are not required to disclose the existence of any criminal convictions that have been expunged or sealed.)
A conviction will not necessarily bar you from employment. Convictions will be considered only as related to the job for which you applied. OK applicants are not required to disclose the existense of criminal convictions that been erased, expunged or sealed.
Convicted of a felony:
If yes, list date(s), offense(s), and where convicted.
If yes, please explain:
Rate your personal computer skills (1 = Poor, no knowledge; 10 = Proficient, extremely skilled)
Describe the computer systems and programs in which you are experienced
Describe any specialized training, apprenticeships and/or skills that you possess that you believe are relevant to the position for which you are applying
Do you have any other experiences, skills, or abilities that you feel especially qualify you for work with our company?
Dates of Service:
Voluntary Equal Opportunity Questionnaire
As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the optional self-identification fields below used for compliance with government regulations and record-keeping guidelines.
Choose Not to Disclose
Hispanic or Latino
White (not Hispanic or Latino)
Black or African American (not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (not Hispanic or Latino)
Asian (not Hispanic or Latino)
American Indian or Alaska Native (not Hispanic or Latino)
Two or More Races (not Hispanic or Latino)
Choose Not to Disclose
Other Protected Veterans
Armed Forces Service Medal Veterans
Recently Separated Veterans
Choose Not to Disclose
PLEASE READ THE FOLLOWING STATEMENT CAREFULLY AND SIGN BELOW.
In consideration of the acceptance of my application by Athlon Solutions LLC, I understand, agree and/or certify to the following:
1. I certify that all information I have provided on this application, and on any other documents submitted with it, is true,
accurate, and complete to the best of my knowledge and belief. I understand that falsification, misrepresentation or
omission of any information on my application, resume, or any other materials, or which I supply during any interviews,
will be justification for withdrawing any offer of employment or, if employed, termination from employment, regardless
of when the falsification, misrepresentation or omission is discovered by Athlon Solutions LLC.
2. Any offer of employment I may receive from Athlon Solutions LLC is contingent upon my successful completion of the Company’s total pre-employment screening process. This process may include, but is not limited to, the following:
a. Receipt by the Company of background information that it considers satisfactory;
b. Passing a screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to a medical examination or an alcohol and/or drug screening at any time at the discretion of Athlon Solutions LLC. I hereby consent to having the results of any such post-offer pre-employment or post-employment medical exam or alcohol and/or drug screening disclosed to the Company.
3. I hereby grant Athlon Solutions LLC. permission to contact all of my present and former employers and those individuals I have listed as personal references (unless specifically excluded in writing). I authorize and request that such employers and references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment. Further, and in accordance with the Fair Credit Reporting Act Disclosure form, which has been provided me, I authorize Athlon Solutions LLC., or its agent, to obtain transcripts from all educational institutions I have attended and to conduct whatever additional investigation (e.g., educational verification, criminal check, motor vehicle record, workers’ compensation records and credit check) which may be needed to obtain or verify information regarding my application, resume, any other materials, or any interviews, or concerning my qualifications for employment. I hereby release all parties from any and all liability for damages arising from furnishing the requested information.
4. I also understand that, if hired, my employment is to be “At Will” and that either I or Athlon Solutions LLC. may terminate my employment at any time, with or without cause, unless the “At Will” arrangement is modified by a written agreement signed by me, the CEO, and the President of Athlon Solutions LLC.
5. I authorize Athlon Solutions LLC. to deduct and/or withhold from my final paycheck any amounts due and owing by me or for my failure to return to Athlon Solutions LLC. any Company property and/or to satisfy any financial obligations to Athlon Solutions LLC. that I have, arising or occurring prior to the date of the issuance of my final paycheck.
6. I understand that my application will remain active for 60 days, and that to be considered for a job with Athlon Solutions LLC., after that, I must reapply.
Format: M/D/YY *