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04 Oct, 2023
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List your most recent employers, starting with your most recent first.
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If yes, when:
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- I am a US citizen or national.
- I am a lawful permanant resident in the US.
- I have recieved political asylum in the US.
- I have been granted refugee status in the US.
- I have been granted temporary residence in the US under the 1986 legalization program.
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Holaday Circuits, Inc. is committed to providing equal employment opportunity to all its employees
and qualified applicants for employment. Various agencies of the government require employers to
request employees and applicants to identify themselves as indicated below. The requested
information will assist us in tracking employee statistics and evaluating our diversity recruiting
efforts. This information is held in confidence and is used only in accordance with applicable
Federal or State government reporting requirements.
COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS DECISIONS REGARDING YOUR APPLICATION.
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Gender:
Race/Ethnic Origin:
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I hereby affirm that the information provided on this application (and accompanying resume, if any)
is true and complete to the best of my knowledge. I also agree that any falsified information or
omissions in any detail may disqualify me from further consideration for employment and may be
considered justification for discharge if discovered at any time.
I hereby agree to submit to any lawful testing that may be required as a condition of my employment
or continued employment and understand that refusal to submit to such testing during the course of
my employment may result in disciplinary action, up to and including discharge.
I further agree, that if employed, I will confirm my conduct to Holaday’s rules and regulations. I
understand that, unless otherwise specifically agreed to in writing by Holaday Circuits, Inc, my
employment is terminable-at-will and may be terminated with or without cause, and with or without
notice, at any time, at either Holaday’s or my own option. This application is not intended to be and
does not constitute a contract for continued employment.
I acknowledge all statements above to be true.
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04 Oct, 2023
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