Application

* Denotes Required Fields

I'm at least 16 years of age *

Personal Details

Social Security No.

- - *

example : 123-45-6789

Employee Name

(First name)

(Middle name)

(Last name)

Current address

Apartment No.

City

State

ZIP

Day Telephone Number

- - *

Evening Or Mobile Telephone Number

- - *

Are you Bilingual(Spanish - English)?

Why are you interested in changing employment?
(100 char. max)

Please provide other names under which you have worked.

Education Details

Are you currently a full-time or part-time student? Yes No

Did you graduate high school ? YesNo
High School Attended
Location of High School

Did you graduate College ? Yes No
College Attended
Location of College

Major course of study in college and degree status

List any honors and/or certifications you've earned(education and/or worked). (100 char. max)

Professional Details

Do you have work experience ? Yes No *

Starting with your most current employer, please provide your work experience, including:

Business name	*	Business type	*
Supervisor's name	*	Supervisor's phone number
Supervisor's title	*
Employment start date(MM/DD/YYYY)	*	Employment end date (MM/DD/YYYY)	*
Duties (100 char. max)	*
Starting salary	*	Ending salary	*
Reason for leaving	*	May we contact this employer?	YesNo*
Add Another Employer's Details

Desired Employment Details

Preferred Employment Type

Preferred Shift

Position applying for

Preferred Work Location

Compensation Expected

If hired, When can you begin working?(MM/DD/YYYY)

Describe the advancement opportunities you’d like to explore with Etech.(100 char. max)

Are you willing to travel ?

Yes No *

What percentage of time are you willing to travel ?

Other Details

Through what person, organization, or advertising source did you learn about employment opportunities with Etech?

Describe your work experience and previous responsibilities that would enable your success with Etech. (100 char. max)

List any additional job-related skills, training, licenses, and/or certificates that may qualify you to perform job related functions in the position for which you are applying. (100 char. max)

Have you ever been employed, or been offered employment, with Berry Direct, Effective Teleservices, Inc. (ETI), or Etech, Inc.?

Yes No *

If yes then what dates ? (MM/DD/YYYY)

Would your employment with Etech, Inc. cause you to violate any employment agreement with present or past employers? (If yes, explain).

Are there any felony charges pending against you?

Yes No *

Have you ever been convicted of a felony or misdemeanor (other than a minor traffic violation)? (You’ll be asked to fill out a background consent form. It is imperative that all background paper work is consistent. Please be honest with your answer.)

Yes No *

Have you ever received deferred adjudication for any misdemeanor or felony crime?

Yes No *

Are you related to anyone within the Etech Inc. organization ?

Yes No *

Disclaimer

Etech, Inc. Is an equal opportunity employer. Discrimination in employment practices because of age, ancestry, race, color, religion, gender, national origin, marital status, physical or mental handicap or status as a disabled veteran or vietnam veteran is prohibited.
Etech, Inc. Reserves the right to drug screen/test. Employment is contingent on passing a background/reference check.
- Etech, Inc. Reserves the right to drug screen/test any employment candidates prior to and randomly thereafter extending a job offer.
- Employment is contingent upon successful completion of a background screening, reference check, and drug screening if conducted.
I understand that I am consenting to an independent investigation conducted by a consumer reporting agency. This investigation could include obtaining information covering up to the last seven (7) years regarding, among other items, references, character, past employment, work habits, education, general reputation, and personal characteristics, subject to state law. The investigation also may include obtaining information relating to criminal convictions without any time limitations, subject to state law.
If hired by Etech, Inc. I will produce proof of identification (i.e., id card with photograph, social security card, u.s. passport,certificate of citizenship or naturalization, an appropriately endorsed foreign passport or green card with photograph). I further certify that I meet the minimum age requirements of applicable laws.
A routine inquiry may be made which will help determine your suitability for employment and verify the information supplied. Upon written request, additional information as to the nature and scope of the report, if one is made, will be provided. I understand that any false answers or statements made by me on this application or any supplement or resume thereto will be sufficient grounds for immediate discharge. I hereby authorize the companies or persons named in this application to furnish any true information regarding me or my employment.
I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Etech, Inc. And me for either employment or for the providing of any benefit. No promises regarding employment have been made to me and i understand that no such promise is binding upon Etech, Inc. Unless make in writing. If employed, I understand that I have the right to terminate my employment at any time, for any reason, and that Etech, Inc. Retains a similar right and that the only manner in which these rights may be altered is by written document signed by the president or chief executive officer of the company.

I have read, understand and agreed to the above conditions.

Date : _____________________

Signature : _____________________

Upon Completion of Application, Please hit SUBMIT.

Note: By clicking the submit button to the right, you are digitally signing this application and acknowledging that this release is signed freely and voluntarily, in consideration of the training to be provided by Etech, Inc. and you also agree to all of the terms stated above.