Job Application - South-Fair Electric

Step 1 of 3

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Date of Application(Required)

MM slash DD slash YYYY

PERSONAL INFORMATION

Full Legal Name(Required)

Address(Required)

Street Address City State ZIP Code

Telephone Number(Required)

Position Desired(Required)

Can you perform the essential functions of the position for which you are applying with or without reasonable accommodations?(Required)

Yes

When are you available to begin work?(Required)

Are you legally eligible to be employed in the United States?(Required)

Yes

Are you over the age of 18 years?(Required)

Yes

Have you ever worked for this Company before?(Required)

Yes

If yes, where?(Required)

When? (Dates)(Required)

Job Title(Required)

Do you have any relatives or friends who work for the Company?(Required)

Yes

If yes, who and where do they work?(Required)

Are you available to work:(Required)

DAYS

NIGHTS

WEEKENDS

FULL TIME

If you cannot work full time, please explain:(Required)

Are you presently employed?(Required)

Yes

If yes, may we contact your employer?(Required)

If presently employed, why are you considering leaving?(Required)

EDUCATION

High School(Required)

Name and Location of School

Course of Study

No. of Years Completed

Diploma or Degree Received

College(Required)

Name and Location of School

Course of Study

No. of Years Completed

Diploma or Degree Received

Vocational/Trade/Graduate School(Required)

Name and Location of School

Course of Study

No. of Years Completed

Diploma or Degree Received

EMPLOYMENT

Start with your current or most recent position:

Employer 1

Name of Employer

Dates Employed

Supervisor's Name/Title

Telephone Number

Full Address

Reason for Leaving

Employer 2

Name of Employer

Dates Employed

Supervisor's Name/Title

Telephone Number

Full Address

Reason for Leaving

Employer 3

Name of Employer

Dates Employed

Supervisor's Name/Title

Telephone Number

Full Address

Reason for Leaving

PERSONAL REFERENCES

Provide two references (not relatives or employers):

Reference 1(Required)

Name

Telephone Number

Reference 2(Required)

Name

Telephone Number

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regarding race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability or genetic information protected by law.

PLEASE READ AND SIGN:(Required)

I understand failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can result in disqualification for employment consideration or, if hired, may be grounds for termination from the company or its' subsidiaries.

I also understand if I am hired, my employment is for an indefinite time and it is subject to termination by myself or South-Fair Electric Contractors, Inc., with or without cause, with or without notice, and at any time. Nothing in the policy or any other policy shall be interpreted to conflict with or to eliminate or modify in any way, the at-will employment status of South-Fair Electric Contractors, Inc. unless the deviation to the policy is in writing and agreed upon with signature by the Executive Vice-President or Human Resources Director.

My signature below also acknowledges my understanding that the application is not intended to constitute a contract of employment, express or implied.

EEO-1 VOLUNTARY SELF IDENTIFICATION FORM

Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for EEO-1 reporting.

If you choose not to self-identify at this time, the federal government requires South-Fair Electric Contractors, Inc. to determine this information by visual survey and/or other available information.

Name

Gender

Please select an option below

Male

Female

I do not wish to disclose

Race/Ethnicity

(Please check one of the descriptions below corresponding to the ethnic group with which you identify.)

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 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.

Native American or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains 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.

I do not wish to disclose.

Date

MM slash DD slash YYYY

Signature

VOLUNTARY SELF-IDENTIFICATION OF DISABILITY

Name

Date

MM slash DD slash YYYY

Employee ID (if applicable)

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 peoplewith disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individualswith 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 https://www.dol.gov/agencies/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, rheumatoidarthritis, 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 Multiplesclerosis (MS)
• Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

Please check one of the boxes below:

Yes, I Have A Disability, Or Have A History/Record Of Having A Disability

No, I Don’t Have A Disability, Or A History/Record Of Having A Disability

I Don’t Wish To Answer

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.