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Employment Application

Application for Employment

Please complete all information requested. Incomplete or unsigned applications will not be considered.
First Name, Last Name
Address
Address
City
State
Zip
Are you legally authorized to work in the United States?
(If hired, proof of citizenship or immigration status will be required.)
Are you at least 18 years of age?
(You must be at 16 years old to work in a manufacturing company.)
Our work SOMETIMES requires overtime, during the regular work week and on weekends. Can you work such a schedule if necessary?
Are you able to perform the communication requirments of this position, with or without reasonable accomodation?
I'm available to work:
Are you currently employed?
Have you been employed by OEM Controls in the past?

Education and Military Experience

Did you graduate?
GED?

Military Experience

College or Technical School

Additional Skills and Qualifications

(e.g., professional licenses and memberships, hobbies, training, offices held, volunteer work, etc.)

Please complete as applicable to this position for which you are applying

Employment Experience

Beginning with your most recent employer, list each employment experience, including temporary assignments, volunteer activities, and part-time work. Please provide all relevant details. You may attach a resume if you have one, but you must complete this portion of the application as well. 

Employer #1

Address
Address
City
State
Zip

Employer #2

Address
Address
City
State
Zip

Employer #3

Employer #4

Address
Address
City
State
Zip

Voluntary Self-Identification

OEM Controls, Inc. is an Equal Opportunity Employer.  We do not discriminate based on race, color, religion, sex, sexual orientation, gender identify, national origin, age, disability, veteran status, or any other protected characteristic under applicable law.

Why we are asking:  For government reporting purposes, we ask candidates to respond to the below self-identification survey.  Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment.  The information will be kept confidential and will not be used in making hiring decisions.

Voluntary Self-Identification

Ethnicity:
Race (select one or more):
Gender:

Voluntary Self-Identification of Veteran Status

I identify as:

Protected Veteran includes:

  • Disabled Veteran
  • Recently Separate Veteran
  • Active Duty Wartime or Campaign Badge Veteran
  • Armed Forces Service Medal Veteran

PROTECTED VETERAN

Disabled Veteran – Any veteran who is entitled to compensation for a disability who has a disability rating of 30 percent or higher; or, a 10 to 20 percent disability rating if the disability has been classified as a serious employment handicap; or who was discharged or released from active military duty because of a disability incurred or aggravated in the line of duty.

Recently Separated Veteran– A veteran who was discharged or released from active duty within the last three years.

Active Duty Wartime or Campaign Badge Veteran - A veteran who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized (e.g., Iraq Campaign Medal, Afghanistan Campaign Medal).

Armed Forces Service Medal Veteran - A veteran who, while on active duty participated in a U.S. military operation for which an Armed Forces Service Medal was awarded.

Voluntary Self-Identification of Disability

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

  • Alcohol or other substance use disorder (not currently using drugs illegally)
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
  • Blind or low vision
  • Cancer (past or present)
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or serious difficulty hearing
  • Diabetes
  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
  • Epilepsy or other seizure disorder
  • Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
  • Intellectual or developmental disability
  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
  • Missing limbs or partially missing limbs
  • Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
  • Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
  • Partial or complete paralysis (any cause)
  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
  • Short stature (dwarfism)
  • Traumatic brain injury

Please check one of the boxes below:

Disability

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

OEM Controls, Inc. is a federal subcontractor subject to compliance with Executive Order #11246 (Affirmative Action). As such, we are required to request the following information from applicants for employment at our Company.

You must answer at least question 1 (out of 6 total questions) in order to submit the form.

Maximum file size: 268.44MB

(.pdf format only)

Applicant's Statement And Release For Reference Checks

My signature below means that I understand and agree to this statement:

I understand that OEM Controls, Inc. follows an “employment at will” policy. This means that if I am hired, I can either resign or the Company can discharge me at any time, with or without notice, for any reason that is not against the law. All employment relationships at OEM Controls are on an “employment at will” basis. No supervisor, manager or representative of the Company, except the Chief Executive Officer, President, Controls Division or President, Data Delivery Division, in a signed writing, has the authority to make any agreement or contract for employment for any specified period of time.

I give permission to OEM Controls, Inc. to contact my former supervisors, companies that I have worked for in the past, and schools which I have attended, for a reference check and to verify information I have provided on this application or during my interview. I give permission to those persons, companies and schools to provide any information requested about me and I release them and OEM Controls, Inc. from all responsibility for damage in providing or obtaining this information. OEM Controls, Inc. will not contact my current employer unless I have specifically given them permission to do so on Page 1 of this application.

If an offer of employment is made, you may be required to complete a separate background check authorization form in accordance with applicable law.

The information I have provided in this Application for Employment is true and complete. I understand that if false statements or omissions are discovered, it may result in my dismissal or refusal of employment.

If I am hired, I agree to follow all Company rules, regulations, policies and procedures.

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