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You can use the text area for a cover letter and any supplementary information you would like to provide about your career goals, availability, best times to contact you, etc.
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Lao Democratic Republic
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Employee Referral" above, please type the persons name that referred you to this position in the " Referred By" box below.
I am authorized to work in this country for any employer
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I require sponsorship to work in this country
My status to work in this country is unknown
I am currently present in the US on an F-1 student visa
Highest Education Level:
High School Diploma / GED
Trade or Technical School Diploma
Format: M/D/YY *
Have you ever been employed by Accuray?
Ever employed by Accuray?:
If yes, when?:
Title of position:
Who was your manager?:
Do you need any accommodations to participate in the Accuray Interviewing/hiring process?
If yes, please describe:
Employment History - Please list your employment history beginning with your most recent job held.:
Education - Include any pertinent educational history (i.e. High School, Vocational or College):
Additional Training, Certifications and Skills
Training, Additional Skills, Activities, Foreign Language Capabilities (include special or technical training and military courses completed)
Other Training and Skills:
DO NOT SIGN THIS FORM UNLESS YOU ARE WILLING TO AGREE TO THE FOLLOWING TERMS AND LIMITATIONS:
Applications are considered only with respect to the particular positions for which they are submitted and which are open at the time of application. Should you wish to be considered for another position or for a future opening in the same position, or if your application information changes, please re-apply.
By signing this application, I hereby certify that I have read and fully completed this application and that the facts set forth in this employment application (and accompanying resume, if any) are true, correct, and complete. I understand that I may be required to verify the information before being offered employment. I understand that if I have provided any false, misleading, or incomplete information or if made any misrepresentations or omissions of any kind, whether given in this application or otherwise, that Accuray may cancel its consideration of hiring me or, if I have been hired, may terminate my employment.
I hereby give Accuray my consent and release to investigate and verify the truthfulness of the information I have provided in this application and to contact employers, organizations, schools, references, and law enforcement agencies. I authorize all references, employers, schools, organizations, and law enforcement agencies to give to Accuray any information that they may have regarding me. I hereby release those persons, employers, schools, organizations, and law enforcement agencies, and all individuals connected with them, from all liability including any claim for damages for releasing this information to Accuray.
Accuray complies with the Immigration Reform and Control Act of 1986. I understand that proof of my right to work in the United States will be required if I am hired.
I agree that if I am employed, I will conform to the policies, guidelines, and regulations of Accuray, as revised from time to time, and agree that those policies, guidelines and regulations do not constitute an employment contract.
Please type your full legal name in the “Electronic Signature” field below. This will serve as your agreement and understanding of the statements above.
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Voluntary Equal Opportunity Questionnaire
As an equal opportunity employer, we hire without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability. We invite you to complete the self-identification fields below used for compliance with government regulations and record-keeping guidelines. Providing self-identification information is voluntary – while the questions are required we ask that you select “Choose Not to Disclose” if you wish not to provide the information requested. If you need any assistance seeking a job opportunity at Accuray, or if you need reasonable accommodation with the application process, please call 408-789-4408 or contact firstname.lastname@example.org.
Choose Not to Disclose
Hispanic or Latino
White (not Hispanic or Latino)
Black or African American (not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (not Hispanic or Latino)
Asian (not Hispanic or Latino)
American Indian or Alaska Native (not Hispanic or Latino)
Two or More Races (not Hispanic or Latino)
Choose Not to Disclose
Campaign Badge for Service During a War or in a Campaign or Expedition
Other Protected Veterans
Armed Forces Service Medal Veterans
Recently Separated Veterans
Choose Not to Disclose
Voluntary Self-Identification of Disability
OMB Control Number 1250-0005
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:
• Epilepsy • Autism
• Cerebral palsy
• 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:
YES, I HAVE A DISABILITY (or previously had a disability)
NO, I DON’T HAVE A DISABILITY
I DON’T WISH TO ANSWER
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.