ELEIT TECHNOLOGY, INCORPORATED

                  EMPLOYMENT APPLICATION

This application must be completed in its entirety and is valid only until the specific position applied for is filled.  One position per application only.  NAME:________________________________________________________________________________________________________ First Middle Last Please list all other names used for education or employment including dates used and circumstances: _______________________________________________________________________________________________________________ PRESENT ADDRESS: ___________________________________________________________________________________________                                                                                                     Street _______________________________________________________________________________________________________________ City State Zip Code PRIOR ADDRESS (IF ANY):   _____________________________________________________________________________________ HOME TELEPHONE: ______________________________________ DAY PHONE:  __ ____________________________________ DATE:  _______________________ POSITION APPLIED FOR:   _________________________________________________________                                                                                 Specific position must be listed or this application is invalid.                                                                                                                One position per application only. ________________________________________________________________________________________________________________ PERSONAL  DATA Social Security No.  ____________________________________ Have you ever applied to ELEIT before?  ___________________    If so, when?  __________________________________________ Expected salary  ______________  Referred by  ______________________  Date available to work  __________________________ If the position for which you are applying requires travel, are you available to travel?    __________Yes       ___________No Do you have relatives now employed with ELEIT?    _________  Yes      _________  No      If Yes, list names:  __________________ Have you ever been previously employed by ELEIT, if so, when and where:     ____________________________________________ Reason for termination:   ______________________________________________________________________________________ Are you at least 18 years of age?    _______ Yes    _______  No Will you accept shift work?    _______  Yes    _______  No Notice:  ELEIT hires only United States citizens and lawfully authorized alien workers.  All applicants must present documentation for permitting lawful   employment in the United States.  Applicants requiring disability-related accommodations for interviews should request them in advance. ELEIT is an Equal Opportunity Employer and applicants are considered without regard to race, color, religion, sex, national origin, age, marital status, veteran status, disability, or any other legally protected status.  Minimum age limits imposed by law are observed.  If selected for employment, a prospective employee must provide satisfactory references, must be able to perform the essential functions of the job with or without reasonable accommodation, sign a nondisclosure or patent agreement if requested, and be granted the necessary U.S. government access authorization, if required.  The prospective employee must agree to complete and sign any company or client-required confidentiality agreements.  Pursuant to the ADA, ELEIT will make reasonable accommodations to enable otherwise qualified individuals to accept employment and to perform their jobs properly and safely. You need not disclose memberships to professional or technical organizations that might reveal information regarding race, color, religion, sex, national origin, age, marital or veteran status, disability or any other legally protected status.  Present and former employees of the Department of Defense affected by Section 931 of the Defense Acquisition Improvement Act of 1986 will be expected   to provide approval documentation from their designated DoD Agency Ethics Official prior to the effective date of their employment with ELEIT. 
201 Triana Blvd. NW, Huntsville, AL 35805 Phone 256-533-4773 FAX256-533-4775 Page 1 of 5 Next Page ELEIT Home