We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age sex, religion, disability, medical condition, national origin, or marital status.

Personal Information

Section 1 - General Information

Section 2 - Employment Verification

Section 3 - Education

Section 4 - Other Training: Certifications/Licenses

Section 5 - Current Employment

Section 6 - Previous Employment

Section 7 - 2nd Previous Employment

(Numeric Answer Only)

Section 8 - Reference 1

Section 9 - Reference 2

Section 10 - Emergency Contact Information

Section 11 - Military Service

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 any document used to secure this position can be grounds for refection of application or , if  am employed by PCMC Inc., terms for my immediate termination from the company.

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without  prior notice, by either me or PCMC Inc.

I permit the company to examaine my references, record of employment, education record, and any other information I have provided.  I authorize the references I have listed to disclose any information related to my work record and my professional expereinces with them, without giving me prior notice of such disclosure.  In addition, I release PCMC Inc., my former employers and all otehr 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.