Employment Application

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Please make use of the following form to apply for a position on the Mikro team.

You may fill out the entire web form, or you may simply complete the “Personal Information” section and upload your résumé in Word or PDF format via the Résumé upload section near the bottom of the form. * Indicates a required field.

Personal Information

* Position Applied for:
* Full Legal Name:
* Mailing Address Line1:
Mailing Address Line2:
* City:
* State:
* Zip Code:
* Phone:
* Email:
Date Available:
Social Security #:

Are you a U.S. Citizen? Yes No

If no, are you legally authorized to work in the U.S.? Yes No

Are you 18 years or older? Yes No

Do you have a valid driver's license? Yes No

Have you ever been convicted of a crime? Yes No

If yes, explain:

Education

High School:
City / State:
Did you graduate? Yes No

College:
City / State:
Did you graduate? Yes No
Degree:

Other Schooling:
City / State:
Did you graduate? Yes No
Degree:

Personal References

Please list three people not related to you who know your qualifications for the job.

Full Name:
Relationship:
Company:
Best Contact Method:
Phone:
Email:

Employment History

Please start with your current or most recent position.

Company:
Phone:
City / State:
Supervisor:
Job Title:
Ending Wage or Salary:
Responsibilities:
From:
To:
Reason for Leaving:
May we contact your supervisor for a reference? Yes No

Company:
Phone:
City / State:
Supervisor:
Job Title:
Ending Wage or Salary:
Responsibilities:
From:

To:

Reason for Leaving:
May we contact your supervisor for a reference? Yes No

Additional Comments, Skills, Qualifications (Optional)

Military Service (if applicable)

Branch:
From:
To:
Rank at Discharge:
Type of Discharge:

If other than honorable, explain:

Upload Your Résumé (Optional)

* Verification and Authorization

I verify that the statements I have made in this application are true and complete to the best of my knowledge, and I understand and agree that, if I become employed by Mikro Systems, Inc., any falsification of information on this application or in any associated résumé or interview may result in my termination, regardless of time of discovery.

I authorize Mikro Systems, Inc. to contact the references, employers and educational institutions specified above regarding this application, and to rely upon and use as it sees fit any information received from such contacts.

By submitting this form I agree to the above listed terms.