Employment Application

Personal Information

Employment Desired


High School

Undergraduate College

Graduate/ Professional

Employment History

List below all present and past employers over the past ten years, starting with your most recent employer. Account for all periods of unemployment. You may attach a resume as a supplement to this section, but please provide as much specific information about former employers as possible (such as name, complete addresses, contact information). This information might be used as part of a background/ reference check/employment verification. If you submit a resume to supplement this section, it shall become an attachment to and a part of this application.

Employment History 1.

Employment History 2.

Employment History 3.

Employment History 4.

Employment History 5.

Additional Information



List below three persons not related to you who have knowledge of your work performance within the last 5 years.

Reference 1

Reference 2

Reference 3

Additional Space

Please read each statement closely and initial after each before signing at the bottom to acknowledge your understanding.

Equal Employment Opportunity Statement

Span, Inc. is committed to complying with all federal, state, and local laws providing for equal employment opportunities, as well as all laws related to terms and conditions of employment. The Company desires to maintain a work environment that is free of harassment and discrimination due to race, color, religion, sex (including sexual orientation, gender identity, or pregnancy), national origin, older age (beginning at age 40), disability, or genetic information (including family medical history), or any other status protected by federal, state, or local laws. The Company will make reasonable efforts to accommodate those physical or mental limitations of an otherwise qualified employee unless undue hardship would result for the Company.

Discrimination and Sexual Harassment Policy Statement

Span, Inc. will not tolerate any form of unlawful discrimination or harassment, including sexual harassment. Any employee who engages in unlawful discrimination or harassment, sexual or otherwise, will be subject to appropriate discipline, up to and including termination.

Disclosure to Applicants Concerning Drug/Alcohol Testing and Background Screening

Subject to the terms and conditions stipulated by the Department of Transportation and the Drug and Alcohol Policy of Span, Inc., you may be given a drug/alcohol test as a condition of employment. Your refusal to timely submit to a drug/alcohol test or your failure to pass such a test means you will likely become ineligible for employment by SPAN, Inc. Additionally, all employees of Span, Inc. will be required to undergo and pass a criminal background screening. Some positions may require further periodic screenings. I understand that depending on the results of the background screening and the position for which I am applying, I may be disqualified as an eligible candidate. I further understand that if I become an employee of Span, Inc. future results of any drug or criminal background screening may make me ineligible for employment and be a cause for termination, depending on the results and the position in which I am employed.

Complete and Accurate Information

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of material fact on this application, or any other document used to secure employment, shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

At-Will Employment

I understand that my submission of this application, does not obligate Span, Inc. to hire me now or in the future. I further understand and agree that if I am employed, my employment will be “at-will”, which means that Span, Inc. may terminate the employment relationship at any time, with or without cause and with or without notice. Likewise, Span, Inc. will respect my right to terminate my employment at any time, with or without cause and with or without notice.

Medical Examination

I understand that if offered certain positions with Span, Inc., I might be required to pass a medical examination to remain eligible for employment.

Investigation Authorization

I authorize investigation into all statements and references contained in this application.

I have read and agree with the statements above made by Span Inc..