Imcon Inc

Employment Application
Please Take A moment And Tell Us About Yourself
Full Name (*)
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Address
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Email
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Are you 18 yrs or older?
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Are you a citizen of the United States?
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If no, are you authorized to work in the U.S?
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EMPLOYMENT DESIRED: PLEASE FILL IN THE FOLLOWING FIELDS
Position Desired:
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Date Available:
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Salary Desired:
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Are you currently employed?
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Supervisor Name:
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Supervisor Phone Number?
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May We Contact Your Current Employer?
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Have you ever worked for this company?
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If yes, list dates:
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EDUCATION: TELL US ABOUT YOUR EDUCATION BACKGROUND
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Completed:
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PREVIOUS EMPLOYMENT: LIST PREVIOUS EMPLOYERS FROM MOST RECENT ON
Previous Employer:
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Other positions held in the company?
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Describe Your Duties:
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REFERENCES SECTION: WE WILL CHECK REFERENCES, SO PLEASE INCLUDE AS MUCH INFORMATION AS YOU CAN
Reference Name:
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Reference Type:
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Years Acquainted:
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Reference 2 Name:
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Phone Number
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Reference 3 Name:
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Years Acquainted:
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Phone Number:
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ACKNOWLEDGMENT AND AUTHORIZATION: I certify that answers given herein are true and complete to the best of my knowledge.
I authorize investigation of all my statements contained in this application for employment as may be necessary to make an employment decision.

This application for employment shall be considered active for a period of time not to exceed 60 days. And one desiring to be considered for employment beyond this time period should inquire as to whether or not applications are being taken at that time.

I hereby understand and acknowledge that unless otherwise defined by applicable law, any employment with Imcon, Inc. or it's subsidiaries is of an "at will" nature, which means that the Employee may resign at any time and the Employer may terminate the Employee at anytime with or without cause. It is further understood that this means "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledge in writing by an executive of Imcon, Inc.

In the event of employment, I understand that false or misleading information given in my application, resume or interview my result in discharge. I understand, also, that I am required to abide by all rules and regulations found in the Employee Handbook and any revisions after the date of my employment.
Electronic Signature:
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Pasadena, TX Office:

5401 Spencer Hwy
Pasadena, TX 77505
(281) 991-1215
Fax (281) 991-1221

Midland, TX Office:

2301 Garden City Hwy.
Midland, TX 79701
(432) 682-3745
Fax (432) 682-6342

Cushing, OK Office:

1908 E. Eseco Road
Cushing, OK 74023
(918) 225-2151
Fax (918) 215-2229