Equal Employment Opportunity Employer

Pro Systems Inc. (PSI) is an Equal Employment Opportunity Employer and hires regardless of race, color, age, national original, marital status, sex, disability, religion or any other legally protected status.

To enable PSI to make a fair appraisal of your qualifications please answer questions fully, truthfully, and accurately.


If you are not a United States citizen, do you have the legal right to secure permanent Employment?
If hired, an executed i-9 form with supporting documents will be required.
Yes    No
Are You Under 18?
Yes    No

Do you have a Valid Driver's License?
The answer to this question is relevant only if the position being applied for requires a driver's license.
If the position requires a valid driver's license, the decision to hire will be subject to review and approval of your motor vehicle record by PSI's insurance carrier.
Yes    No
Has your Driver's License ever been Suspended or Revoked?
Yes    No

Have you ever been convicted for an offense other than a minor traffic violation?
Yes    No
A conviction of a crime is not an absolute bar to employment but will be weighed relative to the position applying for

Have you ever been bonded?
Yes    No

Have you ever been refused a bond?
Yes    No

Education Data

Name of School Location(City & State) Major Grade Point Average No. Of years Attended & Degree

Personal References (Other than Former Employers and Relatives)

Describe any other specialized or professional training or achievements, include study course given through public or private employment. State whether degree or certificate received.

Employment Data

(List all employment in chronological order- Last position first- including military)

May we contact your present employer?
Yes    No
Have you ever been discharged from employment?
Yes    No

Describe briefly the type of work which you are best qualified to do by reason of education, previous employment, or training and tell why you feel qualified for the position for which you are applying. Include any prior training in computer, word processing, etc.

Name of friends and relatives currently employed by PSI and position held:

Minimum base salary required

If offered employment, how soon can you report for work?

If offered employment, would you have steady transportation to work?
Yes    No
If offered employment, do you agree to submit to a drug and alcohol screening?
A successful completion of a drug and alcohol test is a condition of employment with PSI
Yes    No

General Policies

All statements made by applicants of employment on this application form will be carefully checked for truth and accuracy. The use of this form does not mean there are positions open and does not obligate Pro Systems, Inc. this application will be kept on file for ninety days. At the end of this period please submit a new application if you are still interested in a position with Pro Systems, Inc. information obtained concerning an applicant shall be kept confidential, except when necessary for managerial decisions.


I affirm that all the information contained in this application is true, complete, and accurate and that any misrepresentation, falsification or willful omission, herein, shall be sufficient reason for dismissal from, or refusal of employment. I hereby authorize past employers, all references, and any other person to answer all questions asked by Pro Systems, Inc. concerning my ability, character, reputation and previous employment record. I release all such person from any liability or damages on account of having furnished such information. I, also, hereby authorize Pro Systems, Inc. to prepare or cause to be prepared an investigative criminal report and investigative driving record if it is deemed necessary. I understand that no one employed by Pro Systems Inc, has the authority to orally modify the at will employment relationship. I further agree that in consideration of Pro Systems, Inc., undertaking the aforementioned investigation and consideration of my application for employment, I agree that any controversy or disputes arising out of an employment relationship or termination thereof shall be resolved through a fair and binding arbitration. Finally, I agree that Pro Systems, Inc. may terminate my employment at their discretion at anytime during my employment.