Submit a General Application

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
Cell Phone Number:
* Email:
Application Information
* Source:
If other, please specify:
Attachments
Resume:
  - or Upload from:
 
Cover Letter:
  - or Upload from:
 
Application for Employment
It is the policy of Incom, Inc. (“Incom”) to base employment and employment-related decisions and actions (such as recruitment and hiring) in all job classifications without regard to race, color, age, gender, gender identity and expression, sexual orientation, religion, national origin or ancestry, disability, genetic information, active military or veteran’s status, or any other status protected by law.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Incom cannot guarantee employment to all qualified applicants. It is the policy of Incom to offer employment only through a written offer letter signed by an authorized representative of the Company. Verbal statements made by Company representatives do not constitute valid offers of employment.
PERSONAL INFORMATION
* Are you at least 18 Years of Age?:
Yes   No
If under 18, can you provide State-required minor work authorization?:
Yes   No
* Are you legally authorized to work in the United States?:
Yes   No
* If you are hired, will you be able to submit proof of the above?:
Yes   No

EMPLOYMENT DESIRED
* When would you be available to begin work?:
* What are your compensation expectations for this position?:
* Type of employment desired (select all that apply):
  
  
  
* Which shift(s) are you available to work? (check all that apply):
  
  
* Have you applied at Incom before?:
Yes   No
* Have you been employed at Incom in the past?:
Yes   No
If Yes, please provide details (When/Job Title):
* Are you currently employed?:
Yes   No
If so may we inquire of your present employer?:
Yes   No
If presently employed, why are you considering leaving?:

EDUCATION
Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location Did you Graduate? Degree Received Subjects Studied/Major
*
*
Yes   No
*
*
Yes   No
Yes   No

* Briefly describe your knowledge, skills, training and competencies that you feel qualify you to perform the job-related functions in the position for which you are applying.:

EMPLOYMENT HISTORY
Applicants MUST provide a detailed employment history below. Start with your current or most recent employer. If necessary attach a resume to add more employers and give a full employment history.

If you have not had an Employer 2 or Employer 3, you may enter N/A in the required fields.

Incomplete applications will not receive consideration.


EMPLOYER 1

Dates Employed Employer Name & Address Employer Phone
From:
*

To:
*
*

*
*
Job Title Supervisor Name & Title May we Contact?
*
*

*
*
Yes
No
Responsibilities Reason for Leaving
*
*

EMPLOYER 2

Dates Employed Employer Name & Address Employer Phone
From:
*

To:
*
*

*
*
Job Title Supervisor Name & Title May we Contact?
*
*

*
Yes
No
Responsibilities Reason for Leaving
*
*

EMPLOYER 3

Dates Employed Employer Name & Address Employer Phone
From:
*

To:
*
*

*
*
Job Title Supervisor Name & Title May we Contact?
*
*

*
Yes
No
Responsibilities Reason for Leaving
*
*

REFERENCES Please provide three professional references, including at least one supervisor (not relatives).

Name Relationship Phone Number Email

APPLICATION STATEMENT & ACKNOWLEDGEMENT
If you have any questions regarding this statement, please contact our Human Resources Department before signing.

I understand that neither the completion of this application nor any other part of my consideration for employment represents an offer or contract of employment or a promise of future benefits by Incom.

Incom is an at-will employer. I understand that if I am hired, my employment with Incom is voluntarily entered into, and I will be free to resign at any time, for any reason or for no reason at all, with or without notice. Similarly, Incom may terminate the employment relationship at any time, for any reason or for no reason at all, with or without notice, consistent with applicable federal and state law.

I understand that no documents, oral statements, promises or representations regarding the terms or conditions of my employment will alter the at-will relationship or constitute a contract of employment. No such documents, statements, promises or representations may be construed to provide for a definite term of employment or in any way limit my or Incom’s right to terminate employment at will. I further understand that the at-will nature of my employment cannot be changed except by a written employment agreement signed by both the President of Incom and me. I acknowledge that no such agreement has been entered into or proposed.

I acknowledge that any offer of employment is conditional upon my passing a health evaluation, the sole purpose of which is to determine whether, with or without reasonable accommodation, I am capable of performing the essential functions of the position for which the conditional offer is made.

I further understand that any offer of employment is conditional on my passing a screening for illegal and/or unauthorized substances. Drug and Alcohol-Free Workplace Policy

I also understand that if I am hired, I will be required to establish my identity and eligibility for employment in the United States in accordance with U.S. Citizenship and Immigration Services laws and regulations.

I understand that any offer of employment is conditional on my passing a background check that may include criminal record history and information obtained from a consumer reporting agency. I understand that it will be a condition of employment or continued employment for me to authorize Incom to obtain such information, in accordance with federal and state law. I understand that such information will be evaluated on a case-by-case basis and that neither criminal history, nor adverse information on a consumer report, are necessarily bars to employment.

I certify that I am not presently bound by any oral or written agreements with any of my current or former employers that may impose limits on my conduct or that may otherwise impair my ability to perform the duties of the job that for which I am applying at Incom. Specifically, and without limitation, I certify that I am not bound by any non-disclosure, non-solicitation, non-competition, confidentiality, or proprietary information agreements with any current or former employers. I further certify that I am not subject to or otherwise aware of any other legal obligations that, if hired by Incom, would limit my ability to perform the duties of the job for which I have applied. I agree to immediately inform Incom if I subsequently enter into or become aware of any such agreement or obligation.

Note: If you are unable to make this certification, or have any questions about it, please check below. Notify Human Resources immediately and provide a copy of any agreements to which you are a party.

By signing this application I am affirming that I do not now, or at any time in the future, need sponsorship to work in the United States of America

I certify that all the information submitted by me on this application is true and complete. I understand any false information, omissions, or misrepresentations are grounds for denial of my application for employment or, if employed, for termination of employment, regardless of when any such false information, omissions, or misrepresentations are revealed or discovered.

*
I certify that I have read, fully understand, and acknowledge all terms of the foregoing Applicant Statement.


* Please print full name as your electronic signature:
* Date:
Sponsorship question
* Do you now, or at any time in the future, require sponsorship to work in the United States?
Yes
No
VEVRAA Self-Identification Form
Invitation to Self-Identify

VETERANS
This company is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:
  • A "disabled veteran" is one of the following:
    • A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
    • A person who was discharged or released from active duty because of a service-connected disability.
  • A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
  • An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
  • An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Protected veterans may have additional rights under USERRA—the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I identify as one or more of the classifications of Protected Veteran listed above.
I am not a Protected Veteran

Voluntary Self-Identification of Disability CC-305
Voluntary Self-Identification of Disability

Form CC-305
OMB Control Number 1250-0005
Expires 01/31/2020

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

  • Blindness
  • Deafness
  • Cancer
  • Diabetes
  • Epilepsy
  • Autism
  • Cerebal palsy
  • HIV/AIDS
  • Schizophrenia
  • Muscular dystrophy
  • Bipolar disorder
  • Major depression
  • Multiple sclerosis (MS)
  • Missing limbs or partially missing limbs
  • Post-traumatic stress disorder (PTSD)
  • Obsessive compulsive disorder
  • Impairments requiring the use of a wheelchair
  • Intellectual disability (previously called mental retardation)

Please select one of the options below:

* Do you have a disability


*
*
                           Your Name               Today's Date

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Equal Opportunity Employer-Invitation to Self Identify
Incom, Inc. is an Equal Opportunity employer and does not discriminate in hiring or employment on the basis of race, color, age, gender, gender identity and expression, sexual orientation, religion, national origin or ancestry, disability, genetic information, active military or veteran's status, or any other status protected by law.

Under federal law, Incom, Inc. is required to collect and report statistics about its applicants and employees.

To ensure that Incom, Inc. is an equal opportunity employer, we are asking you to submit the following information. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. If you do not want to answer any question, you may leave it blank. The information provided will be held in the strictest of confidence and will be used solely for reporting purposes. We appreciate your cooperation.
Gender:
Female
Male
Race/Ethnicity:
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races

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