Employment Application | Optima

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Optima is an Equal Opportunity/Affirmative Action Employer
As an equal opportunity employer, Optima is committed to a diverse workforce. If you are a qualified individual with a disability or a disabled veteran, you have the right to request a reasonable accommodation if you are unable or limited in your ability to use or access the on-line Optima job application. You may print out and Fax the completed application to (781)569-0228 or request a reasonable accommodation by calling (781)491-0823.
Thank you for your interest in Optima.

Employment Application

PLEASE ENTER INFORMATION AND COMPLETE THIS APPLICATION FORM

Position(s) Applied For: *

First Name: *

Middle Name: *

Last Name: *

Adress: *

Street Address:

City:

State / Province / Region:

Postal / Zip Code:

Country

Telephone Number *

Email address (Please double check that you type it correctly): *

How did you hear about us? *

Craigslist Website

Employment agency

Current Employee

Other

If "Other", please specify.

Are you legally eligible to work in the United States? (Proof of eligibility will be required upon offer of employment): *

Yes

No

Are you over the age of 18 years? (If no, you may be required to provide authorization) *

Yes

No

Do you have a valid driver's license? *

Yes

No

Number of moving violations in the last 5 years: *

Please provide your personal vehicle information: Make, Model, Year:

Have you ever applied to Optima before? *

Yes

No

Have you ever worked for Optima before? *

Yes

No

If yes, please give their name and relationship to you.

What salary or rate of pay do you expect to receive if employed? ($ _______ per ______ ): *

Have you ever been fired or asked to resign from a job? *

Yes

No

If yes, please explain:

On what date would you be available to work?

Month

Day

Year

Days and Hours Available, please be as specific as possible Day Sunday Monday Tuesday Wednesday: *

Education. Please specify below: Name and Location of School / Course or Major of Study / Number of Years Completed / Diploma or Degree for: High School, College, Graduate, Vocational

Please describe any specialized training apprenticeships, licenses or skills

Employment History (Begin with current or most recent employer. Do not exclude any employment. Include any applicable temporary employment. Previous salaries or wages will not be used to determine compensation at Optima). Please be as specific as possible base on the information requested below: 1. Company Name 2. Employment Dates (From _____ to _______ ) 3. Salary / 4. Name and Title of supervisor 5. Address 6. Phone 7. Describe your position and duties 8. Reason and explanation for leaving

Second Employment History (Do not exclude any employment. Include any applicable temporary employment. Previous salaries or wages will not be used to determine compensation at Optima). Please be as specific as possible base on the information requested below: 1. Company Name 2. Employment Dates (From _____ to _______ ) 3. Salary 4. Name and Title of supervisor 5. Address 6. Phone 7. Describe your position and duties 8. Reason and excplanation for leaving

Third employment history

Fourth employment history

References. Please list three persons with contact info. (These should be persons who are not related to you, who can provide professional references.)

Employment Application Voluntary Self-Identification

As an equal opportunity affirmative action employer, the following information is being gathered, not for employment decisions, but for record-keeping in compliance with federal laws and regulations. We ask you to voluntarily assist us our effort to collect the most accurate data by checking below your gender and the one ethnic group with which you most closely identify.

Providing this information is voluntary, and your employment opportunities will not be adversely affected if you respond or decline to respond. If you choose not to self-identify, your gender and ethnicity will be recorded by a company representative based on visual observation. This information will be kept separate and confidential and will only be used in accordance with government and other legal reporting requirements.

Gender:

Female

Male

Race/Ethnicity - To assist in appropriate identification, you may mark the group to which you belong, identify with, or are regarded in the community as belonging to, as defined below:

White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

Black or African (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa

Hispanic or Latino: All persons of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture of origin regardless of race

Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam

American Indian or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America), and who maintained tribal affiliation or community attachment

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands

Two or More Races (Not Hispanic or Latino): All persons who identify with more than one of the above five races

I hereby certify that all of the information provided by me in this application is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts may be cause for denial of employment.

Yes

No

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