Job Application Application for Employment at InspiredLED Inspired LED Job Application: First Name: Last Name: Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Address Phone Number: Email: If hired, can you provide evidence of legal eligibility to work in the U.S.?* If hired, can you provide evidence of legal eligibility to work in the U.S.? Yes No Are you 18 years of age or older?* Are you 18 years of age or older? Yes No Are you fully vaccinated for COVID-19, including booster?* Are you fully vaccinated for COVID-19, including booster? Yes No Are you willing to get the CDC recommended vaccines if required for this job?* Are you willing to get the CDC recommended vaccines if required for this job? Yes No In order to maintain the safest work environment for all employees, are you willing to wear a mask during business hours?* In order to maintain the safest work environment for all employees, are you willing to wear a mask during business hours? Yes No In order to maintain the safest work environment for all employees, are you willing to take a free on-sight nose swab PCR test for COVID-19 on a weekly basis?* In order to maintain the safest work environment for all employees, are you willing to take a free on-sight nose swab PCR test for COVID-19 on a weekly basis? Yes No * Position Desired: Wage / Salary Desired: Education* High SchoolAssociate DegreeBachelor's DegreeGraduate or Professional DegreeSome CollegeOther * Name of High School? City & State * Name of College or Technical School City & State Major? List any job-related skills or accomplishments, including military service: List any job-related skills or accomplishments, including military service: Work Availability* Full Time Part Time Available Start Date:* Available Start Date: MM slash DD slash YYYY Your Availablity for Work* Your Availability for Work Monday Tuesday Wednesday Thursday Friday Total hours per week you are available to work:* Total hours per week you are available to work: Do you have any special requests or needs for a work schedule? Do you have any special requests or needs for a work schedule? References: Name (First & Last) Occupation: How do you know them? How long have you known them? Phone Number: Name (First & Last) Occupation: How do you know them? How long have you known them? Phone Number: Name (First & Last) Occupation: How do you know them? How long have you known them? Phone Number: Work History* May we contact current employers before you are offered a position? Yes No Current (or most recent) Employer: Job Title: Supervisor: Phone Number Address Street Address City State / Province / Region ZIP / Postal Code Address Start Date: End Date: Reason for Leaving Address Starting Pay: Ending Pay: Previous Employer: Job Title: Supervisor: Phone Number Address Street Address City State / Province / Region ZIP / Postal Code Address Start Date: End Date: Reason for Leaving Address Starting Pay: Ending Pay: Previous Employer: Job Title: Supervisor: Phone Number Address Street Address City State / Province / Region ZIP / Postal Code Address Start Date: End Date: Reason for Leaving Address Starting Pay: Ending Pay: Resume & Cover Letter Upload* Drop files here or Select files Accepted file types: pdf, jpg, Max. file size: 50 MB. Please upload your Resume and/or Cover Letter here. Acknowledgement and Authorization Upon submission of this application, I certify that all answers given herein are true and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.