EMPLOYMENT APPLICATION Please complete in its entirety.
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1 EMPLOYMENT APPLICATION Please cmplete in its entirety. Dear Applicant: Thank yu fr inquiring abut emplyment with CnSl. CnSl is the residential prductin builder s energy advcate. We are lking fr exceptinal peple t be part f ur team, helping t make CnSl the emplyer f chice. We strive t be a drug free wrkplace and have zer tlerance fr vilence, discriminatin and harassment f any kind. Our applicatin fr emplyment is quite thrugh. T aid yu in the applicatin prcess, please be sure t fllw these steps: 1. Please review the Emplyment Verificatin Requirements, page 2 f this packet. The dcuments required by the Immigratin Refrm and Cntrl Act are due within three (3) days f the first day f emplyment. There are n exceptins t this requirement. 2. Fill ut the applicatin ENTIRELY. Be sure t give the exact date yu can start. We must have the addresses and phne numbers f all present and past emplyers. Dn t frget t sign the applicatin! We will nt accept any applicatin that is nt signed. Please type r print legibly and in ink. If yu submit yur applicatin via the internet, please make sure t sign it if yu are called in fr an interview. 3. CnSl has a respnsibility t recruit individuals wh are well qualified and have a strng ptential t be prductive in their respective psitins as staff members. Therefre, CnSl cnducts backgrund screening n applicants wh are ffered psitins with the Cmpany. Additinally, fr safety sensitive psitins, we als cnduct drug and alchl testing n applicants wh are ffered psitins. Please cmplete and sign the attached apprpriate frms in rder t prcess the infrmatin shuld yu be ffered a psitin with CnSl. Any ffer is cntingent upn a successful backgrund and if applicable, drug test result. If yu neglect t fllw any f the abve steps, yur applicatin may be greatly delayed, perhaps causing yu t lse ut n an pprtunity t interview. Thank yu fr yur interest in wrking fr CnSl! Last revised Apr
2 EMPLOYMENT IDENTIFICATION REQUIREMENTS The Immigratin Refrm and Cntrl Act, 1986 Public Law require all emplyers t verify prf f identity and emplyment eligibility thrugh prper identificatin. Any persns hired after Nvember 6, 1986, is required t meet the dcumentatin requirements. Please ensure that yu bring with yu the apprpriate identificatin with yu t CnSl Human Resurce Department upn emplyment. If hired, yu will be required t submit the riginal f ne dcument frm List A r ne Dcument frm List B AND ne dcument frm List C, upn yur first day f emplyment. Please see belw fr acceptable frms f identificatin. List A - Dcuments that establish identity and emplyment eligibility: United States Passprt Certificate f United States Citizenship (INS frm N-560 r N-561) Certificate f Naturalizatin (INS frm N-550 r N-570) Unexpired freign passprt which: cntains an unexpired stamp which reads Prcessed fr I-551. Temprary Evidence f Lawful Admissin fr Permanent Residence. Valid until..., Emplyment Authrized ; r has attached theret a Frm I-94 bearing the same name as the passprt and cntains an emplyment authrizatin stamp, s lng as the perid f endrsement has nt yet expired and the prpsed emplyment is nt in cnflict with any restrictins r limitatin identified n frm I-94. Alien Registratin Receipt Card Resident Alien Card (INS I-551) prvided that it cntains a phtgraph f the bearer. Temprary Resident Card (INS I-688) Emplyment Authrizatin Card (INS I-688A) List B Dcuments that establish identity fr individuals 16 years f age r lder: State Issued Drivers License r State Issued Identificatin Card cntaining a phtgraph. Schl Identificatin Card with a phtgraph Vter s Registratin Card United States Military Card r draft recrd Identificatin Card issued by a federal, state r lcal gvernment agency Military dependent s identificatin card Native American tribal dcuments United States Cast Guard Merchant Mariner Card Driver s License issued by a Canadian gvernment authrity Fr Individuals under 16 years f age wh are unable t prduce ne f the dcuments listed abve: Schl recrd r reprt card Clinic dctr r hspital recrd Daycare r nursery schl recrd List C Dcuments that establish identity fr individuals 16 years f age r lder: Scial Security Card, ther than nes printed with nt valid fr emplyment purpses and must be issued frm the Scial Security Administratin, riginal nly. An riginal r certified cpy f a birth certificate issued by a state, cunty r municipal authrity bearing an fficial seal Unexpired INS emplyment authrizatin Unexpired re-entry permit (INS frm I-327) Unexpired Refugee Travel Dcument (INS F=frm I-571) Certificatin f birth issued by the Department f State (frm FS-545) Certificatin f Birth Abrad issued by the Department f State (frm DS-1350) United States Citizen Identificatin Card (INS I-197) Native American tribal dcument Identificatin Card fr use f Resident Citizen in the United States (Frm I-179) 2
3 EMPLOYMENT APPLICATION Please cmplete in its entirety. Please Print All areas are required, please cmplete thrughly. Tday s Date Last Name First Name M Initial Present Address Number & Street City State Zip Hme Phne Cell Phne Alternate Phne Required: Previus Address Number & Street City State Zip Required: Previus Address Number & Street City State Zip Emplyment Desired Full Time Part Time Internship Psitin Applying Fr $ per If Hired, Date Yu Can Start Salary Desired Hw Did Yu Hear Abut This Psitin? What days are yu available fr wrk? Mn Tue Wed Thur Fri Sat Sun Are yu available fr wrk n weekends, if necessary? Yes N Wuld yu be available t wrk vertime, if necessary? Yes N Persnal Infrmatin Have yu ever wrked fr t CnSl befre? Yes N If yes, When Why Did Yu Leave D yu have any friends r relatives wrking fr CnSl? Yes N If yes, state name(s) and relatinship: Name Relatinship Name Relatinship Why are yu applying fr wrk at CnSl? _ 3
4 Persnal Infrmatin (cntinued) If hired, wuld yu have reliable means f transprtatin t and frm wrk? Yes N Are yu currently emplyed? Yes N If s, may we cntact yur current emplyer? Yes N Are yu at least 18 years ld? Yes N (If under 18, hire is subject t verificatin that yu are f minimum legal age.) If hired, can yu present evidence f yur U.S. citizenship r prf f yur legal right t live and wrk in this cuntry? Yes N Are yu able t perfrm the essential functins f the jb fr which yu are applying, either with r withut reasnable accmmdatin? Yes N If n, describe the functins that cannt be perfrmed. Nte: We cmply with the ADA and cnsider reasnable accmmdatin measures that may be necessary fr eligible applicants and/ r emplyees t perfrm essential functins. Hire may be subject t passing a medical examinatin, and t skill and agility tests. Have yu ever been cnvicted f a criminal ffense (felny r serius misdemeanr)? Yes N (Cnvictins fr marijuana-related ffenses that are mre than tw years ld need nt be listed.) If yes, state nature f the crime(s), when and where cnvicted, and dispsitin f the case. Nte: N applicant will be denied emplyment slely n the grunds f cnvictin f a criminal ffense. The nature f the ffense, the date f the ffense, the surrunding circumstances and the relevance f the ffense t the psitin(s) applied fr may, hwever, be cnsidered. Educatin, Training, Experience Name f High Schl Years Cmpleted Degree Graduated Yes N City State Name f Cllege University Years Cmpleted Degree Graduated Yes N City State Name f Cllege University Years Cmpleted Degree Graduated Yes N City State Name f Vcatinal/Business Years Cmpleted Degree Graduated Yes N City State 4
5 Educatin, Training, Experience (cntinued) D yu have any ther experience, training, qualificatins, r skills which yu feel make yu especially suited fr wrk at CnSl (this includes cmputer sftware)? Yes N If s, please explain: D yu btain any licenses r certificatins that may apply t the jb? Yes N Name f License r Certificatin Issuing State License r Certificatin Number (if applicable) Has yur license/certificatin ever been revked r suspended? Yes N If yes, state reasn(s), date f revcatin r suspensin, and date f reinstatement. Emplyment Histry all emplyment histry areas must be cmpleted List belw all present and past emplyment starting with yur mst recent emplyer (last five years is sufficient). Please accunt fr all perids f unemplyment. Yu must cmplete this sectin even if attaching a resume. Name f Cmpany: Type f Business: Address: City: State Zipcde: Dates f Emplyment Frm: T: List Jb Duties: Rate f Pay Start: End: Reasn fr Leaving: May we cntact? Yes N If Yes, cntact: 5
6 Name f Cmpany: Type f Business: Address: City: State Zipcde: Dates f Emplyment Frm: T: List Jb Duties: Rate f Pay Start: End: Reasn fr Leaving: May we cntact? Yes N If Yes, cntact: Name f Cmpany: Type f Business: Address: City: State Zipcde: Dates f Emplyment Frm: T: List Jb Duties: Rate f Pay Start: End: Reasn fr Leaving: May we cntact? Yes N If Yes, cntact: 6
7 Name f Cmpany: Type f Business: Address: City: State Zipcde: Dates f Emplyment Frm: T: List Jb Duties: Rate f Pay Start: End: Reasn fr Leaving: May we cntact? Yes N If Yes, cntact: Military Histry Service Branch Year Have yu btained any special skills r abilities as the result f service in the military? Yes N If s, describe: References Please give names f three persns whm yu have knwn fr at least ne (1) year and wh have persnal knwledge f yur wrk histry and skills. DO nt include any relative unless the relative was yur emplyer, manager and is s identified. Prfessinal Persnal Name and Phne Number Business Yrs. Knwn Name and Phne Number Business Yrs. Knwn Name and Phne Number Business Yrs. Knwn 7
8 Please Read Carefully, and Sign Belw I hereby certify that I have nt knwingly withheld any infrmatin that might adversely affect my chances fr emplyment and that the answers given by me are true and crrect t the best f my knwledge. I further certify that I, the undersigned applicant, have persnally cmpleted this applicatin. I understand that any missin r misstatement f material fact n this applicatin r n any dcument used t secure emplyment shall be grunds fr rejectin f this applicatin r fr immediate discharge if I am emplyed, regardless f the time elapsed befre discvery. I hereby authrize CnSl t thrughly investigate my references, wrk recrd, educatin and ther matters related t my suitability fr emplyment and, further, authrize the references I have listed t disclse t the cmpany any and all letters, reprts and ther infrmatin related t my wrk recrds, withut giving me prir ntice f such disclsure. In additin, I hereby release the cmpany, my frmer emplyers and all ther persns, crpratins, partnerships and assciatins frm any and all claims, demands r liabilities arising ut f r in any way related t such investigatin r disclsure. I understand that emplyment with CnSl is f an at-will nature. I understand that nthing cntained in the applicatin, r cnveyed during any interview which may be granted r during my emplyment, if hired, is intended t create an emplyment cntract between me and the cmpany. In additin, I understand and agree that if I am emplyed, my emplyment is fr n definite r determinable perid and my emplyment may be terminated at any time, with r withut cause and with r withut ntice at any time by the emplyee r the Cmpany. Signature Date Check here if Internet Submitted. This applicatin must be signed immediately if called in fr an interview. 8
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