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Employment Application

Home/Careers/Employment Application
Employment ApplicationVision Design

Step 1 of 8

12%

  • Personal Data

  • Date Format: MM slash DD slash YYYY

  • General Information

  • Education Data

  • High School

  • Technical, Vocational, Business or Military Training

  • College or University

  • Graduate School

  • Professional Seminars

  • Employment History

  • Present & Former Employers

    List Present or Most Recent Employer First – Please complete even if a resume is attached. Attach additional sheet if necessary.

  • Employment 1

  • Employment 2

  • Employment 3

  • Employment 4

  • Employment 5

  • Employment 6

  • Time Period(s)Reason(s) for Unemployment 

  • References

    List Three Business Related Individuals

  • Reference 1

  • Reference 2

  • Reference 3

  • Other Job-Related Experience

  • Please Read Carefully and Initial Each Paragraph Before Signing

  • By my signature and initials, I promise that the information provided in this employment application (and accompanying resume, if any) is true and complete, and I understand that any false information or significant omissions may disqualify me from further consideration for employment, and may be justification for my dismissal from employment by Catalytic Combustion Corporation if discovered at a later date. I agree to immediately notify Catalytic Combustion Corporation if I should be convicted of a felony, or any crime involving dishonesty or a breach of trust while my job application is pending, or during my period of employment, if hired.
  • I authorize any person, school, current employer (except as previously noted), past employer(s), government or investigative agencies, and other organizations that may be named in this application form (and accompanying resume, if any) to provide the company with relevant information and opinion that may be useful to Catalytic Combustion Corporation in making a hiring decision, and I release such persons and organizations from any legal liability in making such statements.
  • I understand that, if hired, I may not hold other employment, nor engage in consulting, sales, investments or other activities that may create a conflict of interest with Catalytic Combustion Corporation.
  • I understand that this application does not, by itself, create a contract of employment. I understand and agree that, if hired, my employment is for no definite period of time, and may, regardless of the date of payment of my wages or salary, be terminated at any time. I understand that only the President of Catalytic Combustion Corporation is authorized to change any of the terms of employment and that any changes must be specific and in writing.
  • Date Format: MM slash DD slash YYYY
  • Accepted file types: pdf, doc, docx, jpg, jpeg.

  • Invitation to Applicants to Self-Identify for Affirmative Action Purposes

    This company prepares affirmative action plans that cover females, minorities, protected veterans, and individuals with disabilities. This survey is meant to help the company fulfill various objectives in these affirmative action plans. PLEASE NOTE: You are not required to complete any part of this form. Submission of this form is voluntary. The decision not to complete this form will not affect any opportunity for employment or any benefits with the company. Any information you provide in this survey will be kept confidential and will not be used in any way that may adversely affect your employment with this company.
  • Date Format: MM slash DD slash YYYY

  • Affirmative Action Related Data

    Please check appropriate boxes
  • (If you checked "Not Hispanic" above, please check one or more of the boxes below.)
  • If you believe you belong to any of the categories of protected veterans listed below, please indicate by checking the appropriate box. As a government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

  • Protected Veteran Categories:

    Disabled Veteran - A disabled veteran is one of the following: (a) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs or (b) a person who was discharged or released from active duty because of a service connected disability.
    Recently Separated Veteran - A recently separated veteran is a veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
    Active Duty Wartime Or Campaign Badge Veteran - An active duty wartime or campaign badge veteran is a veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense. (Note: The term “Active Duty Wartime Veteran” includes, but is not limited to, a veteran who served any time between 8/5/64 and 5/7/75, any time between 8/2/90 and the present day, as well as during various military conflicts defined as qualifying events by the Department of Defense.)
    Armed Forces Service Medal Veteran - An armed forces service medal veteran is a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

  • Voluntary Self-Identification of Disability

  • Why are you being asked to complete this form?

    We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce will be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about his form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

  • How do I know if I have a disability?

    You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:
    • Autism
    • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
    • Blind or low vision
    • Cancer
    • Cardiovascular or heart disease
    • Celiac disease
    • Cerebral palsy
    • Deaf or hard of hearing
    • Depression or anxiety
    • Diabetes
    • Epilepsy
    • Gastrointestinal disorders, for example, Crohn's disease, or irritable bowel syndrome
    • Intellectual disability
    • Missing limbs or partially missing limbs
    • Nervous system condition for example, migraine headaches, Parkinson's Disease, or Multiple Sclerosis (MS)
    • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression
  • Date Format: MM slash DD slash YYYY

  • Reasonable Accommodation Notice

    Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
  • i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.