• Please list previous address if address has changed during the past 5 years.
  • Education

  • References

  • Please enter a value between 0 and 99.
  • Complete this section for office positions only.

  • Additional Info

  • I certify that the information given above is complete and correct to the best of my knowledge and I understand that any misrepresentation or omission of material facts, are grounds for immediate dismissal. I authorize the companies, schools, persons and others named as references to furnish Access Optics and its affiliate companies with any information they may have regarding me and agree they shall be not liable in any respect should my employment be terminated because of misrepresentation or omission of material facts in this application. I agree to a medical examination and/or drug screening analysis when job offer is extended, if requested. In consideration of my employment by Access Optics or one of its affiliate companies, I agree to conform to the rules and regulations of Access Optics and I understand and agree that my employment and compensation with Access Optics or one of its affiliate companies may be terminated with or without cause and with or without notice at any time at the option of myself or the company.

  • DISCLOSURE TO and AUTHORIZATON BY EMPLOYMENT APPLICANT REGARDING PROCUREMENT OF BACKGROUND CHECK, CONSUMER REPORT, DRUG SCREEN TESTING In connection with your application for employment, we may procure or cause to be procured a background check, consumer report, and drug screening on you as a part of the process for considering your candidacy as an employee. In the event that information from the report is utilized in whole or in part in making an adverse decision, we will provide you with a copy of the consumer report and a description in writing of your rights under the law. By your signature below, you hereby authorize us to obtain a background check, consumer report about you, and authorizes us to obtain drug screening in order to consider you for employment, and it is your agreement that you waive and release all claims you may have against the Company which arise out of the Company’s obtaining a background check, consumer report or drug screening test.