• BILL ANSKIS COMPANY, INC.

    465 Industrial Park Rd, Elyburg, PA 17824; Tele: 570-644-0146/Fax: 570-644-3906
  • Employment Application

  • COMPANY EEO POLICY STATEMENT

    It is the policy of this company to assure that applicants are employed, and that employees are treated during employment without regard to their race, religion, sex, color, national origin, age, or disability. Such action shall include: Employment, upgrading, demoting, or transfer; recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship, pre-apprenticeship, and/or on the job training.
  • Applicant Information

  • Education

  • References

    Please list three professional references
  • Previous Employment

  • Military Service

  • Additional Comments

  • Disclaimer and Signature

    I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
  • VOLUNTARY SELF IDENTIFICATION FORM

    Bill Anskis Company, Inc. is an equal Opportunity Employer. As required by law, we must record certain information to be made part of our Affirmative Action Program. Applicants for employment are also invited to participate in the Affirmative Action Program by reporting their status as handicapped, disabled veteran, veteran of the Vietnam era or other minority. In extending this invitation you are also advised that: (a) workers (applicants) are under no obligation to respond, but may do so in the future if they choose; (b) responses will remain confidential within the Human Resources Department; and (c) responses will be used only for the necessary information to include in our Affirmative Action Program. We are a company that values diversity. We actively encourage women and minorities to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.
  • Please Complete the following information requested below. Thank you for your cooperation.

    Applicant Information
  • Self Identification

    Please Check All That Apply (see below for definitions)
  • Race or Ethnic Identity

  • Gender

  • Veteran Status

  • I do not wish to self-identify.

  • How did you find out about our opening?


  • EE0 RACE/ETHNIC IDENTIFICATION CATEGORIES AND DEFINITIONS

  • Hispanic or Latino

    A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
  • White (Not Hispanic or Latino)

    A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
  • Black or African American (Not Hispanic or Latino)

    A person having origins in any of the black racial groups of Africa.
  • Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)

    A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
  • 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 (Not Hispanic or Latino)

    A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
  • Two or More Races (Not Hispanic or Latino)

    All persons who identify with more than one of the above five races.
  • Veteran of the Vietnam Era

    Defined as a veteran who (a) served on active duty in the Republic of Vietnam between February 28, 1961 and May 7, 1975, or (b) served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged or released there from with other than dishonorable discharge, or (c) was discharged or released from active duty for a service-connected disability if any parts of his or her active duty was performed between August 5, 1964 and May 7, 1975.
  • Other Eligible Veteran

    Defined as any veteran who served in a “war” declared by Congress, in a campaign or on an expedition for which a campaign badge, service medal, or an expeditionary medal has been awarded.
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