Step 1 of 9 11% Name* First Middle Last Suffix Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Secondary PhoneEmail* Referred by Position Applied for* Available Start Date MM slash DD slash YYYY Desired Salary* Are you employed now?* Yes No Are you a citizen of the United States?* Yes No If no, are you authorized to work in the U.S.* Yes No Have you ever applied to D&S Engineering Labs?* Yes No If yes, when?* Education*Starting with high school, tell us about your education. SchoolYears AttendedGraduatedCollege EducationCollege NameYears AttendedGraduated Certifications Special Training Special Skills U.S. Military or Naval Service and Rank Employment*NameAddressEmployer CityEmployer StateEmployer Zip CodeEmployers Phone NumberStarting with your most recent employer. Start Date* MM slash DD slash YYYY End Date* DD slash MM slash YYYY EmploymentNameAddressEmployer CityEmployer StateEmployer Zip CodeEmployers Phone NumberStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY EmploymentNameAddressEmployer CityEmployer StateEmployer Zip CodeEmployers Phone NumberStarting with your most recent employer. Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY May we contact your previous employers?* Yes No Professional References*Please list at least three professional references.Full NameCompanyRelationshipYears KnownPhone NumberProfessional References*Please list at least three professional references.Full NameCompanyRelationshipYears KnownPhone NumberProfessional References*Please list at least three professional references.Full NameCompanyRelationshipYears KnownPhone Number Please read carefully and completely before Signing*“I hereby affirm that the information provided is true and complete to the best of my knowledge. I understand and agree that any falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal, if discovered at a later date. I further affirm that I am completing this application because I am sincerely interested in being employed by the company and not for any other purpose. I understand that if conditionally offered employment, I will be asked to give consent to criminal and/or other background checks as a condition of employment. I further understand that refusing to consent to the background check will result in not being considered for employment. I agree to cooperate in the conducting of such background check(s), and release from all liability or responsibility all persons or entities requesting or supply or information in the course of such background check(s). If offered employment I agree to abide by the safety rules and other employment policies of the Company. I also understand that if employment is offered and accepted, such employment is not for any specific term and can be terminated at any time, with or without notice, by either the company or myself. I further understand that this application is not nor is it intended to be a contract or for employment or continued employment, and that my at-will employment status cannot be changed except by a written document by the President of the Company. I further understand that no supervisors, manager, or other employee representative of the Company, other than the President, has the authority to change the at-will nature of my employment and that any oral promises of the employment for a definite period or that are otherwise contrary to my at-will status are not binding upon the company.” I have read and agree to the statement above. Affirmative Action SurveyGovernment agencies require a periodic report on the sex, ethnicity, handicapped, and veteran status of applicants. This data is for analysis and affirmative action only. Submission of information about handicap is voluntary. Male Female EthnicitySelect Your ethnicityAmerican Indian or Alaska Native.AsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteCheck if any of the following are applicable: Vietnam Era Veteran Special Disabled Veteran Other Protected Veteran Disabled Individual Upload Resume File*File Types Accepted — .doc, .docx, .pdf, .rtfAccepted file types: doc, docx, pdf, rtf, Max. file size: 2 MB.Cover LetterFile Types Accepted — .doc, .docx, .pdf, .rtfAccepted file types: doc, docx, pdf, rtf, Max. file size: 2 MB.D&S is an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity.