APPLICANT CERTIFICATION & AGREEMENT: (Read carefully before signing)
I certify that this information contains no willful misrepresentation or falsification and that the information given by me is true and complete to the best of my knowledge and belief. I understand that if employed, misleading or falsified statements on this application may be considered cause for dismissal.
I authorize Holtmeier Construction, Inc. to check all references from current and previous employers and any person listed as a reference on this application that may be relevant to my employment. I authorize the Company to verify any of the information furnished in this application. I authorize all persons, schools, companies, and law enforcement agencies to release any information concerning by background that may be relevant to evaluation of this application and I hereby release any such persons, schools, companies and law enforcement agencies from any liability or damages whatsoever for issuing this information to this company and/or its agents.
If employed, I agree to conform to the rules, regulations and policies of the company. I understand that I will be an employee "at-will" and either the company or I may terminate my employment relationship at any time for any reason not in violation of the law. At no time shall any oral statement by the management of Holtmeier Construction, Inc. be construed as giving rise to or creating a contract for employment between Holtmeier Construction, Inc. and me or any other employee, or otherwise alter or modify the "at-will" nature of the employment relationship.
I understand Holtmeier Construction, Inc. prohibits the use and possession of controlled substances and/or alcohol on its premises. As required by the company's policies, I am willing to submit to drug and alcohol testing to detect the use of illegal drugs or alcohol prior to and during employment.
I understand Holtmeier Construction, Inc. participates in a WorkSteps program to evaluate physical attributes of candidates as a condition of employment. The information obtained by the independent third party for WorkSteps is not shared or provided to Holtmeier Construction, Inc. or its management.
I hereby acknowledge that I have read and fully understand the foregoing and seek employment under these conditions.
Enter your name in the text box below to sign your application and agree to these terms.
Equal Employment Opportunity
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.
The Information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.
Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender
Male
Female
I choose not to disclose this information
Ethnicity
Hispanic or Latino (a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race)
Not Hispanic or Latino (if not Hispanic or Latino, please address race below)
I choose not to disclose this information
Race (do not respond if you selected "Hispanic or Latino" above)
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, the Middle East, or North Africa
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
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
Two or More Races (Not Hispanic or Latino)
A all persons who identify with more than one of the above five races
I choose not to disclose this information
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:
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.
I am not a Protected Veteran
I choose not to disclose this information
Disability Status
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.
Yes I have a disability (or previously had one)
No I don't have a disability
