Job Application e-Form

Name: First Name(required)

Last Name(required)

Present Address: Street(required)

Present Address: City(required)

Present Address: State(required)

Present Address: ZIP(required)

Phone:(required)

Email:(required)

Have you served in the U.S. Armed Forces?(required)

Yes No

Have you previously applied to Gemini?(required)

Yes No

Do you presently have any relatives working for Gemini?(required)

Yes No

How were you referred to Gemini? Please be specific:(required)

Are you legally authorized to work in the U.S.?(required)

Yes No

Are you under the age of 18?(required)

Yes No

Are you able to travel as part of the job:(required)

Yes No

Are you able to work overtime if required:(required)

Yes No

Will you relocate if job requires it?(required)

Yes No

Do you now or in the future require immigration sponsorship from Gemimi Technologies to obtain, retain, or extend your authorization to work in the United States?(required)

Yes No

Please list the highest level security clearance and access you currently hold:

Position Applied For:(required)

Minimum Desired Annual Salary:(required)

Is amount negotiable?(required)

Yes No

Date Available:(required)

ETHNICITY/RACE: (identify one or more race categories)

Hispanic or Latino or identify a race listed below White (not Hispanic or Latino) Black or African American (not Hispanic or Latino) Black or African American (not Hispanic or Latino) Native Hawaii or Other Pacific Islander (not Hispanic or Latino) American Indian or Alaska Native (not Hispanic or Latino) Two or more races (not Hispanic or Latino) Do not wish to identify

GENDER CATEGORIES

Male Female Do not wish to identify

PROTECTED VETERAN CATEGORIES

Protected Veteran Not a Protected Veteran Do Not Wish to Identify

Please check one of the boxes below: Please check one of the boxes below:

YES I HAVE A DISABILITY (or previously had a disability) NO I DON’T HAVE A DISABILITY I DON’T WISH TO ANSWER

Today's Date mm/dd/yyyy(required)

Job Application e-Form

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