APPLICATION FOR EMPLOYMENT

  • APPLICATION FOR EMPLOYEMENT

    An Equal Opportunity Employer

  • We do not discriminate on the basis of race, color, religion, national origin, sex, age, or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

    Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. Be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non job-related information.

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  • Today's Date*
     - -
  • Are you seeking:*
  • Format: (000) 000-0000.
  • Are you 18 years of age or older? (If you are hired, you may be required to submit proof of age).*
  • If hired, can you furnish proof you are eligible to work in the U.S.?*
  • Have you ever applied here before?*
  • Were you ever employed here?*
  • Have you ever been convicted of any law violation (except a minor traffic violation)?*
  • Are you now or do you expect to be engaged in any other business or employment?*
  • For Driving Jobs Only: Do you have a valid driver's license?*
  • Have you had your drivers license suspended or revoked in the last 3 years?*

  • LIST NAME AND ADDRESS OF SCHOOLS

  • MSEC 1.1a (2/95)
  • List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references. Note: A job offer may be contingent upon acceptable references from current and former employers.
  • DATES OF EMPLOYMENT: FROM *
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  • DATES OF EMPLOYMENT: TO *
     - -
  • Format: (000) 000-0000.
  • DATES OF EMPLOYMENT: FROM
     - -
  • DATES OF EMPLOYMENT: TO
     - -
  • Format: (000) 000-0000.
  • DATES OF EMPLOYMENT: FROM
     - -
  • DATES OF EMPLOYMENT: TO
     - -
  • Format: (000) 000-0000.
  • DATES OF EMPLOYMENT: FROM
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  • DATES OF EMPLOYMENT: TO
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  • Format: (000) 000-0000.
  • Have you worked or attended school under any other name?*
  • Are you presently employed?*
  • Have you ever been fired from a job or asked to resign?*

  • PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

  • I cetify that all information provided in this employment application is true and complete, I understand that any false infonnation or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.
  • I understand that the employer may request an investigative consumer report from a consumer reporting agency. This report may include information as to my character, reputation, personal characteristics and mode of obtained from interviews with neighbors, friends, former employers, schools and others. I understand I have a right to a reasonable time for the disclosure of the name and address of the consumer reporting agency so that I may obtain a complete disclosure of the nature of I authorize the investigation of any or all statements contained in this application, I also authonze whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may useful in making a hiring decision. I release such persons organizations any legal liability in making such statements.
  • I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing acomplete mployment physical examination. I consent to the release of any or ali medical information as may be deemed necessary to judge my capabilily to do the work for which I am applying. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post employment drug screen as a sondition of employment, required.
  • I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOY- MENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME. WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE
  • I have read, understand, and by my signature consent to these statements.
  • Date:*
     - -
  • This application for employment will remain active for a limited time. Ask the organization representative for details.

  • Skills Evaluation Sheet

  • (to be completed with Application for Employment)
  • Date*
     - -

  • Production/Shop Applicant: Please complete this self-evaluation of your skill levels listed below. Rate your skills from highest (4) to lowest (0) by typing the appropriate  number next to each skill. If no comments, simply type N/A.

  • Rows

  • Voluntary Self-Identification Survey Form

  • Applicant - Affirmative Action Employer

  • TO ALL APPLICANTS:

  • Our company is an Affirmative Action/Equal Employment Employer and as such, we are required to collect and maintain information related to applicants in order to meet governmental recordkeeping and reporting requirements and to monitor the effectiveness of our outreach, recruitment and other employment practices.
  • At this time, we are asking you to help us meet our obligations by providing the information listed on the following pages. Please note that the information will be used only in accordance with the provisions of applicable laws, executive orders, and regulations. Providing this information is voluntary and refusal to so will not result in any adverse treatment. The information you provide will be held in strict confidence except that:
  • 1) Necessary management and supervisory personnel may be informed to ensure proper placement and to provide reasonable job accommodations;
  • 2) First aid and safety personnel may be informed to the extent appropriate, if the condition might require emergency treatment; and
  • 3) Government officials investigating affirmative action program compliance may have access to reported information.
  • Thank you for your cooperation in this important initiative.
  • 1220 Exhibits Inc abides by the requirements of federal laws which prohibit discrimination of individuals with the following legally protected status: race, color, religion, sex, sexual orientation, gender identity, national origin, disability and protected veterans. 1220 Exhibits Inc also abides by affirmative action requirements to employ and advance in employment qualified individuals without regard to race and sex (per Executive Order 11246), disability (per 41CFR 60-741.5(a), and protected veteran status (per 41CFR 60-300.5(a).

  • PART I. General Information

  • Date:*
     - -

  • PART II: Referral Source: Please indicate how you heard about this opening

  • Referral Source*
  • Form CC-305
    Page 1 of 1

  • Voluntary Self-Identification of Disability

  • OMB Control Number 1250-0005

  • Why are you being asked to complete this form?

  • We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.
    Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

  • How do you know if you 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:
    • Autism
    • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
    • Blind or low vision
    • Cancer
    • Cardiovascular or heart disease
    • Celiac disease
    • Cerebral palsy
    • Deaf or hard of hearing
    • Depression or anxiety
    • Diabetes
    • Epilepsy
    • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
    • Intellectual disability
    • Missing limbs or partially missing limbs
    • Nervous system condition for example, migraine headaches, Parkinson's disease, or Multiple sclerosis (MS)
    • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

  • Please check one of the boxes below:

  • Please check one of the boxes below:*
  • 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.

  • For Employer Use Only

  • Employers may modify this section of the form as needed for recordkeeping purposes.
  • For example:

  • PART III. Gender, Ethnicity and Race Information:

  • Gender

  • CHECK ONE:*

  • Ethnicity

  • CHECK ONE:*

  • Race

  • CHECK ONE: (do not respond if you selected Hispanic or Latino above)*
  • Please continue to next page to identify veteran status.

  • PART IV. Protected Veterans

  • The definitions of protected veterans are listed below. Use the boxes following the definitions to indicate whether you are a protected veteran
  • Disabled Veteran
  • 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.
  • Recently Separated Veteran 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.
  • Active Duty Wartime or Campaign Badge Veteran
  • 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.
  • Armed Forces Service Medal Veteran
  • 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.
  • CHECK ONE:
  • Protected Veteran Status*
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  • Should be Empty: