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Application for Employment

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Equal Opportunity

We adhere to policies in business and employment that are conducted without discrimination based on race, color, genetics, religion, gender, national origin, age, marital status, veteran status, disability or any other protected class. Your consideration for employment will be based solely upon the qualifications you possess and your perceived ability to perform, with or without reasonable accommodation, the essential job functions of the position for which you are applying. Accuform also makes accommodation for religious observances, which Accuform determines reasonable.

Completing the Application

This online application consists of several different sections of questions about you and your history. Please fill out all required fields honestly and completely. The more information you provide, the easier it becomes for us to match you to positions suited to your skill set, knowledge and experience.



If you answered other or internet, please explain.

Contact Information



What position you were interviewed for? Or, if hired, what was your title?
If you worked with Accuform, why did you leave?
How are you related to this person? Is it your father? Cousin? Neighbor? Friend?
Include any and all instances even if adjudication was withheld.
Responding 'yes' does not automatically disqualify you for employment. Please explain the circumstances.
Controlled substances such as cocaine, marijuana, hallucinogens, etc?
Please explain the circumstances.
Please explain the circumstances.
Please explain the circumstances.

Military History - Complete this section if you served in the U.S. Armed Forces.



e.g. Lapeer East High School, Lapeer, MI
e.g. High School Diploma, GED, etc.
e.g. Manatee Technical Institute
e.g. Associate Degree
e.g. Florida State University
e.g. Bachelor of Fine Art

Employment History


Business-Related Reference


Pre-Employment Household Income Certification

Required Documentation
As part of Accuform's participation in the Small Cities Community Development Block Grant Program, all applicants are required to complete a copy of the Pre-Employment Household Income Certification Form. This information is for data-collection purposes only. It is strictly confidential and reported directly to the Department of Economic Opportunity. Although required, the data collected is not used in any way in the consideration of an applicant for employment. We are committed to helping our community grow!

How many people live in your household?

For households of more than 8 persons, contact Accuform for more information with which to complete this seciton of the income certification.
After completing the Persons in Household question, answers above should be one of the following: Very Low, Low, Moderate, N/A

Household Composition

Indicate how many people in each of the following categories reside in the household. Some household members may need to be counted in more than one category. Enter ‘0’ (zero) in any field where the category does not apply to any household member.


Race and Ethnicity

For your household, please indicate the quantity of each member, regarding their race, and then enter the number of those of Hispanic ethnicity. Enter ‘0’ (zero) if the category does not apply.

Total In
# of those


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Notifications and Confirmations

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General Information

We are an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, sex, religion, national origin, age, disability, handicap, marital status, or any other basis protected by law. The opportunity for employment will be based solely upon your qualifications and ability to perform the job for which you are being considered. We also reasonably accommodate individuals with disabilities, handicaps, and bona fide religious beliefs.

We comply with the Americans With Disabilities Act of 1990. During the interview process, you may be asked questions concerning your ability to perform job-related functions. You may also be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. Upon request, all entering employees in the same job category will be required to complete the same medical questionnaire and/or examination. All medical information will be kept confidential.

We also maintain a Drug-Free Workplace in accordance with all applicable State and Federal regulations; copies of which, together with the employee's Drug-Free Workplace Policy, are available for inspection at all reasonable times by applicants or employees upon request.

Please read and sign the statements below.

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You may upload a resume or cover letter here. Files may be in MS Word format or PDF (.doc, .docx or .pdf).
Enter your name here to digitally sign this document. By signing this document, you are attesting to the certification and all confirmations listed above.

If you see this field, please do not enter data. It exists to stop malicious scripts from hurting our site.
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