Maxim BiomedicalInnovation for a
Healthier World

Application for Employment

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Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical, mental disability, or veteran status.

    Position Applied for:

    Position title(s)*:
    How did you hear of this opening?*
    Date available to start*:
    Salary Requirements*:
    Interested in*:
    Ideal Number of Hours*:
    List your hours of availability below, and please add "am" or pm":
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    Are you legally authorized to work in the U.S. on an unrestricted basis?* Will you now or in the future require sponsorship for an employment visa?* Have you ever been employed by Maxim Biomedical? Do you have relations to a current Maxim Biomedical employee? Do you have reliable means of transportation to work?

    Personal Information

    Last name*
    First name*
    Middle Name


    Street Address*


    City*
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    Telephone*
    Email*

    Education History

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    Years Attended
    Major/Degree


    List any professional license(s) or certification(s) you hold.


    Special Skills, Expertise, and Qualifications: (Foreign language fluency, etc.)


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    Employment History

    List all present and past employment beginning with the most recent. You may enter "N/A" if you cannot complete required* fields.
    Employer*:

    Employed from*: to*
    Employer's Location:
    Position Title*:
    Position Type:
    Reason for Leaving:
    May we verify employment:
    Employer:

    Employed from: to
    Employer's Location:
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    Reason for Leaving:
    May we verify employment:
    Employer:

    Employed from: to
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    Hour Rate/Salary: to
    Reason for Leaving:
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    References

    Please provide professional references only (this can include former employers, client, colleague, teacher, supervisor, etc.)
    Name*: Job Title*: Email:
    Company Name*: Phone*:
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    Company Name: Phone:
    Name: Job Title: Email:
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    Agreements

    After an offer of employment is made, a pre-employment baseline HIV test and a pre-employment drugs of abuse test may be required by Maxim Biomedical as a condition of employment. These tests are arranged by and at the expense of Maxim Biomedical and will be performed at a licensed clinical laboratory by licensed medical personnel. By applying for employment at Maxim Biomedical, I acknowledge my understanding and agreement: (1) the results of my pre-employment baseline HIV test will be held in confidence by the testing laboratory and will only become known to me and to Maxim Biomedical in the event I are involved in an industrial accident where such information may be required; and (2) failure on my part to successfully complete the required post-offer, pre-employment drugs of abuse test may result in Maxim Biomedical rescinding the employment offer and terminating my employment. I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. Please sign (digitally or physically) below acknowledging your understanding and acceptance of the above terms and conditions of employment at Maxim Biomedical.