Employment Application


Company Company Address Company Phone Employment Dates





Name Address Phone Relationship

MID-TEC, INC. HAS A COMMITMENT TO MAINTAIN A DRUG FREE WORKPLACE.
MID-TEC, INC. REQUIRES A DRUG SCREENING TEST AS A PART OF ITS SELECTION AND HIRING PROCESS.
MID-TEC, INC. PARTICIPATES IN E-VERIFY.


I certify that the answers provided to the questions on this form are true to the best of my knowledge.


I authorize Mid-Tec, Inc or its designated representative(s) to obtain information regarding my driving record in any state at any time while I am employed by (or seeking employment with) the company.

I understand that any misstatement of the facts on this form may be grounds for termination of employment.
In the event that my MVR indicate that I am a "High Risk Driver" as defined by the insurance industy, I understand that I may be subject to dismissal.