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Pyramid Technologies
45 Gracey Avenue - Meriden, CT 06451
Toll-free (US/Canada): 888.4.PYRAMID
Phone: 203.238.0550
Pyramid Time Keeping Made Simple
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Application For Employment
Applicants for employment are considered without regard to race, creed, color, religion, sex, sexual orientation, marital status, genetic information, national origin, age, disability, status as a veteran, Vietnam Era Veteran, or being a member of the Reserves or National Guard. Also it is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Position(s) Applied For
Referral Source:
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Relative
Walk-In
Employment Agency
On-Line
Company Web Site
Other

First Name:
Middle Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
Are you under 18:
If employed and you are under 18, can you furnish a work permit?
Have you filed an application here before?
If yes, give date:
Have you ever been employed here before?
If yes, give date:
Are you employed now?
May we contact your present employer?
(Proof of authorization to work and of your identity will be required upon employment)

On what date would you be available for work?
Are you available to work:
Full Time
Part Time
Shift Work
Temporary
Over Time
Are you on a lay-off and subject to recall?
Can you travel if a job requires it?
Copyright © 2005, Employers Association of the NorthEast, Inc.


SEALED RECORD NOTICE
An applicant for employment with a sealed record on file with the Commissioner of Probation may answer “no record” with respect to an inquiry herein relative to prior arrests, criminal court appearances or convictions. An applicant for employment with a sealed record on file with the Commissioner of Probation may answer “no record” to an inquiry herein relative to prior arrests or criminal court appearances. In addition, any applicant for employment may answer “no record” with respect to any inquiry relative to prior arrests, court appearances, and adjudications in all cases of delinquency or as a child in need of services which did not result in a complaint transferred to the superior court for criminal prosecution.

Within the past five years, have you been convicted of a misdemeanor? (Applicants may answer “no” with respect to a first conviction for drunkenness, simple assault, speeding, minor traffic violations, affray or disturbance of the peace).    
If yes, please explain:
Have you ever been convicted of a felony?
If yes, please explain:


LANGUAGES
Indicate what languages (including English) you speak, read, and / or write.

 Speak
Fluently
Good
Fair

 Read
Fluently
Good
Fair

 Write
Fluently
Good
Fair


REFERENCES
Give name, address and telephone number of three references who are not related to you. (previous employers preferred)

 Reference #1
Name
Address
Phone

 Reference #2
Name
Address
Phone

 Reference #3
Name
Address
Phone


Special Skills and Qualifications
Summarize special skills and qualifications acquired from employment or other experience:


Employment Experience
Start with your present or last job. Include military service assignments and any verified work performed on a volunteer basis. You may exclude organization names which indicate race, creed, color, religion, sex, sexual orientation, marital status, results of genetic testing, national origin, age, disability, status as a veteran, Vietnam Era Veteran, or being a member of the Reserves or National Guard.

 Employment Experience #1
Employer
Address
City
State
Zip
Job Title
Supervisor
Reason for Leaving
Phone
Fax
Starting Hourly Rate / Salary
Ending Hourly Rate / Salary
Start Date
End Date
Work Performed

 Employment Experience #2
Employer
Address
City
State
Zip
Job Title
Supervisor
Reason for Leaving
Phone
Fax
Starting Hourly Rate / Salary
Ending Hourly Rate / Salary
Start Date
End Date
Work Performed

 Employment Experience #3
Employer
Address
City
State
Zip
Job Title
Supervisor
Reason for Leaving
Phone
Fax
Starting Hourly Rate / Salary
Ending Hourly Rate / Salary
Start Date
End Date
Work Performed

 Employment Experience #4
Employer
Address
City
State
Zip
Job Title
Supervisor
Reason for Leaving
Phone
Fax
Starting Hourly Rate / Salary
Ending Hourly Rate / Salary
Start Date
End Date
Work Performed


Education
Years Completed
Describe Specialized Training, Apprenticeship, Skills, and Extra Curricular Activities
Honors Received

 Elementary
Name of School

 High School
Name of School
Diploma / Degree
Describe Course of Study

 College / University
Name of School
Diploma / Degree
Describe Course of Study

 Graudate / Professional
Name of School
Diploma / Degree
Describe Course of Study

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 company/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 company/organization.

AGREEMENT: I certify that the information of on this application is true, complete and correct. I hereby authorize the investigation of my past employment, education and activities and I release from all liability all persons, companies and corporations supplying such information. 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.

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