AN EQUAL OPPORTUNITY EMPLOYER M/F/V/H
DRUG FREE WORKPLACE

This application is active for 90 days from the date on the application. If you want to be considered again, you need to reapply.

Start with your present or last job. Include military service assignments and volunteer activities. If more space is required, continue entries on a separate sheet arranged as below and attach to application. Resumes are welcome, but may not be substituted for completion of the information requested below.

VERSEVO Inc. is concerned with the health and safety of all of its employees. Consistent with this philosophy, we strive to create a “drug/alcohol” free work environment. In order to be qualified for employment at VERSEVO Inc., each person offered employment with VERSEVO Inc. will be required to pass a drug screen. This drug screen will require prospective employees to provide a urine sample. A confirmed positive test result, or refusal to submit to a drug screen, will disqualify that person from further consideration for employment with VERSEVO Inc.

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize VERSEVO Inc. to contact previous employers to verify my past employment record and authorize prior employers to release such information to VERSEVO Inc. representatives. I recognize that a copy of this authorization and release is as valid as the original and should be considered as such. I understand that this application is not and is not intended to be a contract of employment. In the event of my employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal laws and state laws.

Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or disability.

As employers/government contractors, we comply with government regulations and affirmative action responsibilities.

Solely to help us comply with government record keeping, reporting and other legal requirements, please fill out the Data Record. We appreciate you cooperation.

This data is for periodic government reporting and will be kept in a Confidential File separate from the Application for Employment.

Government agencies require periodic reports on the sex, ethnicity, disability and veteran status of applicant. This data is for analysis and affirmative action only. Submission of information is voluntary.