Transco Group Employment Application

Transcription

1 Transco Group Employment Application Transco Railway Products Inc. Bucyrus, OH Buffalo, NY Oelwein, IA Logansport, IN Newton Falls, OH Williamsport, PA Toledo, OH Miles City, MT Sioux City, IA Personal Information Name (Last, First, MI) Street address Last Name, First Name: Home phone number Social security number Employment Desired Position applied for Work phone number address Driver s license number/state/expiration (if job involves any driving) How did you hear about this position? available for work Desired hours (full time, part time, etc.) Desired Education Name and of School Course of Study Total Years of Study Degree/ Diploma High School Undergraduate College Graduate/ Professional Other (Specify) List any seminars, classes or other education not listed above which may help qualify you for this position (if you need additional space, please use page 7): Today s : - 1-

2 Employment Application Employment History List below all present and past employers over the past ten years, starting with your most recent employer. Account for all periods of unemployment. You must complete this section even if attaching a resume. May we contact your current employer? YES NO Employer (current Yes No) Start Supervisor(s) ing Employer Start Supervisor(s) ing 2. [PLEASE CONTINUE ON NEXT PAGE] - 2-

3 Employment Application Employment History Employer Start Supervisor(s) ing 2. Employer Start Supervisor(s) ing 2. [PLEASE CONTINUE ON NEXT PAGE] - 3-

4 Employment Application Employment History 5. Employer Start Supervisor ing Employer Start Supervisor ing 2. [PLEASE CONTINUE ON NEXT PAGE] - 4-

5 Employment Application Additional Information Have you ever been employed with this company before? Yes No If Yes, when? Do you have any friends or relatives employed by this company? Yes No If Yes, please provide their names and relationship to you: Are you currently employed? Yes No May we contact your employer? Yes No Are you currently on lay off status and subject to recall? Yes No If you are under 18 years of age, can you provide proof of your eligibility to work? Yes No If hired, can you provide proof of U.S. citizenship or proof of your legal right to work in the U.S.? Yes No Are you able to perform all of the essential functions of the job for which you are applying with or without reasonable accommodation? Yes No If hired, are there any accommodations the company would need to provide so that you can perform all those essential functions and duties of the position being applied for? If Yes, please explain: Yes No If driving is a requirement of the position applied for, have you in the last 7 years been convicted of Driving Under the Influence (DUI) Yes No N/A If hired, do you have a reliable means of transportation to and from work? Yes No If hired, would you be able to travel or work overtime as needed? Yes No Have you ever been convicted of a felony or misdemeanor? Yes No If Yes, please explain: - 5-

6 INSTRUCTIONS FOR ANSWERING APPLICATION QUESTION ABOUT BEING CONVICTED OF A CRIME OR OTHER STATE-SPECIFIC REQUIREMENTS A criminal record does not constitute an automatic bar to employment and will be considered only as it substantially relates to the job in question. Criminal History and State Specific Requirements: Applicants should thoroughly read and carefully follow the applicable state instructions before answering the criminal history questions. In the event of a conflict with this application, applicable State laws govern: Connecticut: Applicants are not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased. Any person whose criminal records have been erased is deemed to have never been arrested within the meaning of the law as it applies to the particular proceedings that have been erased, and may so swear under oath. Illinois: Applicants are not obligated to disclose sealed or expunged records of conviction or of arrest record. Ohio: Applicants are not obligated to disclose criminal convictions that have been sealed, unless the conviction could have a direct and substantial relationship to the position sought. Texas: Applicants are not obligated to disclose expunged records of conviction. Employment Application References List below three persons not related to you who have knowledge of your work performance within the last 5 years Name Occupation Company name Telephone Relationship & years acquainted Name Occupation Company name Telephone Relationship & years acquainted Name Occupation Company name Telephone Relationship & years acquainted - 6-

7 CERTIFICATION STATEMENT I certify that the statements made by me in this application are true, complete and correct to the best of my knowledge. I understand that any material misrepresentation or omission from this application may be grounds for rejection of my application or termination of subsequent employment with The Transco Group (Transco). I understand and agree that any employee handbook and/or code of business conduct I may receive will not constitute an employee contract, but will be merely a gratuitous statement of Transco s current policies. I hereby authorize Transco and/or its agents to make independent investigation of my background, references, past employment, education, criminal or police records, including those maintained by both public and private organizations and all public records, for the purpose of confirming the information contained on my application and/or obtaining other information which may be material to my qualifications for employment. In addition, I hereby authorize my current and former employer(s) to release information pertaining to my work record, my work habits, and my work performance while in their employ and any school (college, university, or vocational/trade) to release my official records to Transco. I release Transco, its employees and agents, and any person or entity which provides information pursuant to this authorization, from any and all liabilities, claims, or lawsuits in regards to the information obtained from any and all of the above. At Transco we are concerned about employees health and safety. We support the Drug Free Workplace Act. Federal and state laws and Transco policies prohibit the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance in the workplace or reporting to work under the influence of a controlled substance. I agree to abide by these requirements if employed by Transco. As a condition of employment, applicants will be required to undergo and pass drug and/or alcohol testing prior to employment and if hired certain positions will be subject to drug and alcohol testing throughout their period of employment. Certain positions may be subject to ongoing medical monitoring. I understand that if hired, I will be an at-will employee, which means that Transco or I may end my employment at any time with or without cause. YOUR APPLICATION WILL BE CONSIDERED INCOMPLETE IF THIS NOTICE IS NOT SIGNED AND DATED. The following is my true and complete legal name: Please Print FULL NAME: OTHER NAMES USED: PRESENT ADDRESS: FORMER ADDRESS: (Signature) () - 7-

8 VOLUNTARY SELF IDENTIFICATION The Equal Employment Opportunity Commission (EEOC) requires organizations with 100 or more employees to complete an EEO 1 report each year. The EEOC has recently announced several changes to the job categories and rearranged its race and ethnicity groupings. We ask that all applicants complete a voluntary self identification sheet below so that we can properly maintain our records according to federal agency reporting requirements. Completion of this data is voluntary and will not affect your opportunity for employment or terms or conditions of employment. This form will be used for EEO 1 reporting purposes only and will be kept separate from all other personnel records only accessed by Human Resources Department. Please return completed forms to the Human Resources Department. NAME: DATE COMPLETED: JOB TITLE: Please check all options that apply below: Male Female Veteran Disability 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 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 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 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. REFERAL SOURCE: How did you hear about this position? Candidate/Employee Signature: PLEASE RETURN FORM TO HUMAN RESOURCES DEPARTMENT. Thank you for your participation. - 8-