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Applicant Information
Name *
Your phone *
Your phone
Current address *
Current address
Date available to start
Date available to start
Have you ever applied to or worked for Simplex before?
Do you have any friends, relatives, or acquaintences working for Simplex?
Are you legally authorized to work in the United States? *
Proof will be required upon employment
Will you now or in the future require sponsorship for an employment visa status? *
Have you ever been convicted of a criminal offense (felony or misdemeanor)? *
A conviction will not necessarily result in the denial of employment
Resume & Cover Letter
Add a link to your LinkedIn profile page or online resume
If you don't have an online resume, enter your unformatted resume text below.
Please list below three persons who have knowledge of your performance within the last five years. Please include at least two professional references.
Reference 1
Reference 1 Name
Reference 1 Name
Phone number
Phone number
Reference 2
Reference 2 Name
Reference 2 Name
Reference 3
Reference 3 Name
Reference 3 Name
Please read and initial each paragraph, then sign below
This application is truthful and forthcoming
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true and correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure employment can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.
Employment is at will
I understand that if I am employed, my employment is at will and can be terminated at any time either with or without prior notice, and by either me or the company.
Authorization of disclosure
I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references and employers I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
Authorization of background check
I authorize Simplex at its discretion to conduct a background check. Job-related background verification may consist of prior employment verifications, professional licensure, personal or professional references, certification of education or other certifications. As appropriate, other background checks may also be conducted. Your employment offer may be subject to the satisfactory findings of one or more completed background checks.
Type your name to sign
Today's date *
Today's date