[{"id":"3b0c2182-0b2e-42e9-80a5-f5455d30a7aa","order":1,"text":"[Company legal name]","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"bb928a47-d3b3-466d-8c4e-8ab941baacd5","order":2,"text":"[Street address] — [City, State and ZIP code]","fontSize":"12","textAlign":"center","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"b9a5c2f5-b705-41ad-a6d4-c26f53b92631","order":3,"text":"[Company website or careers page]","fontSize":"12","textAlign":"center","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"2f7473b7-b6ea-4a4f-a1c7-2ad0c815240a","order":4,"text":"APPLICATION FOR EMPLOYMENT","fontSize":"22","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"bfbe56c8-6e82-454b-b4bd-16185180917a","order":5,"text":"Equal Opportunity Employer — all qualified applicants are considered without regard to any characteristic protected by law.","fontSize":"12","textAlign":"center","bold":false,"underline":false,"marginBottom":"26","cflou":false,"active":true},{"id":"658a1d0f-d377-4d43-8bf4-38008d5862e2","order":6,"text":"NOTICE TO APPLICANTS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true},{"id":"193903b2-a2d1-40f5-8f19-6ede62e38e20","order":7,"text":"Please read this notice before completing the application. Complete every section that applies to you, answer each question fully and accurately, and sign and date the certification at the end. An incomplete or unsigned application may delay or prevent consideration of your candidacy. You may attach a resume or curriculum vitae, but it does not replace this application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ee0816d0-d008-43cf-85fa-e5092b0d6a2a","order":8,"text":"Do not provide your date of birth, your Social Security number, a photograph, or information concerning your marital or familial status, religion, national origin, citizenship status, disability, medical or genetic history, pregnancy, sexual orientation or gender identity. [Company legal name] neither requests nor considers that information when evaluating applications, and any such information volunteered will be disregarded.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"278f70c8-9e6f-466a-861f-a2ac185b2f51","order":9,"text":"Return the completed application to [Name and title of the person receiving applications], by email to [Email address for applications], or by mail or through the online portal at [Mailing address or online application portal].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"e04eb073-1f63-4c2c-9ff6-6f97837bae52","order":10,"text":"If you require a reasonable accommodation in order to complete this application or to take part in any stage of the selection process, contact [Name and title of the accommodation contact]. Requests may be made by email or by telephone at [Contact for applicant requests]. Requests are handled confidentially, you need not disclose the nature of any medical condition in order to make a request, and no adverse action is taken because a request is made.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"742bb3a9-321a-4278-8e44-49ad977d7cf3","order":11,"text":"Genetic information. The Genetic Information Nondiscrimination Act of 2008 prohibits an employer from requesting or requiring genetic information of an applicant or of an employee, or of the family member of an applicant or of an employee. Do not provide any genetic information when answering any question in this application or when responding to any request for medical information. Genetic information includes the family medical history of an individual, the results of a genetic test of an individual or of a family member, the fact that an individual or a family member has sought or received genetic services, and genetic information relating to a fetus carried by an individual or by a family member, or to an embryo lawfully held by an individual or by a family member using an assisted reproductive technology.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"280756aa-bd0e-4571-b047-eb53d3efe97c","order":12,"text":"You are not required to disclose the user name, the password or any other means of access to a personal online account or social media account, no such disclosure is requested, and you are not required to add any person to the contacts associated with such an account or to alter its privacy settings.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"bad159c9-a7ec-48a3-be8e-ab6a8709c3b1","order":13,"text":"No polygraph or other lie detector test is required, requested, suggested or caused to be taken at any stage of the selection process, except where the Employee Polygraph Protection Act of 1988 expressly permits it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"eb96f35e-f53b-4de1-8172-26ce67e607b1","order":14,"text":"This application is not an offer of employment. Neither this application nor any statement made during the selection process creates a contract of employment or a promise of employment for any fixed term. Applications are kept active for consideration for ninety (90) days from the date received. That period is distinct from the period for which records are retained, which is fixed by law and is not less than one (1) year.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"de01840a-a710-40d3-8e40-31688a001f04","order":15,"text":"1. INTERPRETATION AND DEFINED TERMS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S01"},{"id":"19b6b99f-d342-4854-a841-5a187e42935e","order":16,"text":"In this application the following terms have the meanings given to them below, and a reference to a statute is a reference to that statute as amended and to any regulation made under it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4b5bbc67-45f5-4a9a-815a-33726d41ace9","order":17,"text":"Employer means [Company legal name], together with any person acting on its behalf in the conduct of the selection process.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"3202dfa5-6138-4408-b0c2-362fb3499a60","order":18,"text":"Applicant, and the words you and your, mean the person completing and signing this application. A reference to a present employer, to a former employer or to a prospective employer is a reference to a person other than the Employer.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"d2d30809-bade-4f1d-ae27-b41d4933aa06","order":19,"text":"Conditional Offer means an offer of employment that has been made and that remains subject only to the satisfaction of the pre-employment requirements identified at the time the offer is made.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"8d72231c-dd4e-4a75-afa3-8eaa123e320d","order":20,"text":"Consumer Report and Investigative Consumer Report have the meanings given to them by the Fair Credit Reporting Act.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"169bdc69-5b52-42a4-805a-233248af32b2","order":21,"text":"Protected Characteristic means any characteristic protected by federal law, by the law of the State of [State] or by an applicable local ordinance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"62aac3e9-c4be-42c3-a852-88cb84c8546e","order":22,"text":"Business Day means a day other than a Saturday, a Sunday or a legal holiday in the State of [State].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"a63e62b1-8cf3-4df4-a223-c6f007a5cd13","order":23,"text":"A heading is inserted for convenience only and does not affect the construction of this application. Words importing the singular include the plural, and the word including is to be read as being without limitation.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"e258f4c5-c4af-425e-a76a-48b04870dbd0","order":24,"text":"2. EQUAL EMPLOYMENT OPPORTUNITY AND REASONABLE ACCOMMODATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S02"},{"id":"47e2751a-3e3e-40cf-a8fe-ce8962c926fd","order":25,"text":"[Company legal name] is an equal opportunity employer. All employment decisions, including recruitment, screening, interviewing, hiring, placement, compensation, training, promotion, discipline and separation, are made on the basis of job-related qualifications, merit and business need.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"46ff008e-8a7c-435f-9584-137f2062581a","order":26,"text":"[Company legal name] does not discriminate against any applicant or employee on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, lactation and related medical conditions), sexual orientation, gender identity or expression, national origin, ancestry, age (forty (40) years and over), physical or mental disability, medical condition, genetic information, marital or familial status, status as a victim of domestic violence, military or veteran status, citizenship or immigration status lawfully authorizing work, or any other characteristic protected by federal law, by the law of the State of [State], or by applicable local ordinance.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a421aa83-3560-4065-b67c-248ad40ca11e","order":27,"text":"This policy is applied in accordance with Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967, the Americans with Disabilities Act of 1990 as amended, the Equal Pay Act of 1963, the Genetic Information Nondiscrimination Act of 2008, the Pregnant Workers Fairness Act, the Uniformed Services Employment and Reemployment Rights Act, the Immigration and Nationality Act, and all other applicable federal, state and local fair-employment laws.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"55d95b41-a6a7-43b7-8e86-fd5f1defcc3a","order":28,"text":"Reasonable accommodation. Reasonable accommodations are provided to qualified applicants with disabilities, to applicants with known limitations arising out of pregnancy, childbirth or related medical conditions, and to applicants whose sincerely held religious beliefs, observances or practices conflict with a selection procedure or a job requirement, unless the accommodation would impose an undue hardship. Any pre-employment inquiry into a medical condition or a disability is made only after a Conditional Offer, is asked of all entering employees in the same job category, and is kept in a file separate from the application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"46924c47-2330-48bd-a41e-666488efea02","order":29,"text":"Retaliation prohibited. No adverse action is taken against any applicant because that applicant has requested an accommodation, opposed a practice believed to be unlawful, filed a charge or complaint, or taken part in an investigation or proceeding under any fair-employment law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"fd17a26e-53ad-4f7e-99a5-291127ec9993","order":30,"text":"3. POSITION APPLIED FOR","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S03"},{"id":"6af560fa-8e6f-4ad2-914d-18f83d65e978","order":31,"text":"Position: [Position title]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"4028d240-e052-45e0-be11-b629d665e367","order":32,"text":"Department or business unit: [Department or business unit]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"1d0bfac6-4174-421f-a8b8-88376bfc9e7e","order":33,"text":"Work location: [Work location]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"cdeb7b6c-63ba-4854-a7f2-30aded25f4ec","order":34,"text":"Job reference or requisition number: [Requisition number]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"12e26e85-6425-4d64-95d3-0713fac29051","order":35,"text":"Type of employment offered: Full-time","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"88c28b2a-d5f2-44cf-bf35-69fbf3e30b5a","order":36,"text":"Closing date for applications: [Closing date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"0d8300ad-cc07-4758-a5b8-ec3f24d80e4e","order":37,"text":"Date on which you would be available to begin work: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"44daa5b8-9d1b-456d-b590-07a2179495b7","order":38,"text":"Are you able to perform the essential functions of the position, with or without a reasonable accommodation? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"3d9b4a5e-18a2-44c3-9214-234ead61168f","order":39,"text":"Have you previously applied to, or been employed by, the Employer? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"05ad21bb-264d-46d5-8924-40091721449b","order":40,"text":"If yes, state the location, the position and the approximate dates: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"c88c0b18-258c-477d-a4e0-06ba770614a6","order":41,"text":"Compensation and salary history. In accordance with the salary-history and pay-transparency requirements of the State of [State] and of applicable local ordinance, the Employer does not request, require, rely upon or seek from any third party your current or prior compensation, and you are not required to disclose it. Any such information volunteered will not be used to set your pay.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"restricted","type":"add","operator":"="}]},{"id":"b0f06ce8-185f-415c-8921-d50f19ed325f","order":42,"text":"The pay range for this position is [Pay range for the position]. Compensation within that range is determined by job-related factors, including experience, skills, education, licensure, geographic location and internal pay equity. A description of the benefits offered with the position is available on request.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"restricted","type":"add","operator":"="}]},{"id":"d25fd56d-0d75-4982-9d2f-c71c796235e9","order":43,"text":"You may, but are not required to, state your compensation expectations: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"restricted","type":"add","operator":"="}]},{"id":"ac2b6300-52fb-422c-9597-c8d13367397c","order":44,"text":"Compensation. Any information you give about your current or prior compensation is voluntary and is used only to the extent permitted by law. It is never used as a substitute for an assessment of your qualifications, and a refusal to provide it will not affect the consideration of your application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"permitted","type":"add","operator":"="}]},{"id":"8f20b538-c28d-45fc-84ea-aeeeba33ef5a","order":45,"text":"Current or most recent compensation (optional): ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"permitted","type":"add","operator":"="}]},{"id":"d32ced4d-341b-498d-adcf-1f32aeffdc10","order":46,"text":"Compensation expectations: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"9b7fb2cd-d340-4ebd-ad89-e3af41e0f926","value":"permitted","type":"add","operator":"="}]},{"id":"8be2e312-3506-48e7-b9ed-2e9d868b4c1f","order":47,"text":"4. APPLICANT INFORMATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S04"},{"id":"019df7bc-32c2-43ef-8d55-29908fb5f589","order":48,"text":"Full legal name (first, middle, last): _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"f0aa5aac-c648-4be8-8d49-7a3cdb6146df","order":49,"text":"Any other name under which your education or employment records are filed: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"2202571c-dafc-4529-86e7-5b11e38b1c77","order":50,"text":"Street address: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"cd14976b-889e-48ac-9249-8f0efabd117e","order":51,"text":"City, state and ZIP code: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"3403dca5-bbdd-40a5-b0f6-1355756b306f","order":52,"text":"Telephone: ____________________________ Alternative telephone: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"0264e386-5176-45d5-aadc-388e6b825440","order":53,"text":"Email address: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"6a26bd47-dc4e-4605-b50a-cc88f7c4a36b","order":54,"text":"Preferred method of contact: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"055f68c8-150c-4fb6-91f2-00ad28ff68e6","order":55,"text":"Are you at least eighteen (18) years of age? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"8d20029a-a7d5-4b5e-aefe-d13fd585c3b8","order":56,"text":"This question is asked solely to establish compliance with child labor and minimum-age laws. If you are under eighteen (18), any employment is subject to the applicable hours, occupation and work-permit restrictions. Do not state your date of birth on this application.","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"b75569a9-8c2b-4384-b638-164bf666c69c","order":57,"text":"5. AVAILABILITY AND WORK SCHEDULE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S05"},{"id":"a0d9f25a-2eac-4a02-9ce5-5bc4cbdae713","order":58,"text":"The following questions are asked only in order to establish whether you are able to meet the requirements of the position. If your availability is limited by a disability, by a sincerely held religious belief, observance or practice, by pregnancy, childbirth or a related medical condition, or by any other matter for which an accommodation may be required, an accommodation will be considered on request and no adverse inference is drawn. You are not asked to state, and you should not state, the reason for any limitation upon your availability.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"12","cflou":false,"active":true},{"id":"89948eeb-627c-4aa1-943c-5d0a076cafff","order":59,"text":"Days and hours during which you are available to work: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"d02ee085-bf7b-40f6-b300-a25bd587b6a5","order":60,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"c4a6bc66-ab7d-4294-bd72-efae9b270d36","order":61,"text":"Earliest time at which you are available to begin work each day: ____________________________ Latest time at which you are available to finish: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"5736d0b2-2546-49f6-8392-bceb28877239","order":62,"text":"Are you available to work overtime where the position requires it? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"6ba1d791-7f21-4f81-97f8-0739a405bf9f","order":63,"text":"Are you available to work evenings, nights, weekends or holidays where the position requires it? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"5039d292-05f3-4fb7-87c5-578bbba79440","order":64,"text":"Are you able to travel where the position requires it? Yes ________ No ________ Approximate proportion of working time: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"f4186f73-576e-4d3a-9313-427008f70fb3","order":65,"text":"Would you be willing to relocate where the position requires it? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"22509d72-cc27-489c-a6c4-178bd576ee40","order":66,"text":"Is your availability limited in any way of which the Employer should be aware in scheduling interviews? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"d1705794-d53c-4b3a-a3ec-48737543e21b","order":67,"text":"6. EMPLOYMENT ELIGIBILITY AND WORK AUTHORIZATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S06"},{"id":"cbed150e-9250-4945-b948-d9be80590ae7","order":68,"text":"Are you legally authorized to work in the United States for the Employer? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"38693c49-3bbc-4ea8-83e3-fc271995880b","order":69,"text":"Will you now, or in the future, require the Employer to commence or to sponsor an immigration case in order to employ you (for example, a petition for employment-based visa status)? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b1c02881-46d1-41cf-9bbd-87deaf17e25c","order":70,"text":"No question is asked about your citizenship status, your national origin, your immigration status or your place of birth, and no adverse action is taken on any of those grounds. Consistent with the Immigration Reform and Control Act and with the anti-discrimination provision of the Immigration and Nationality Act, any offer of employment is conditional upon your completion of Form I-9 and upon your presenting, within three (3) Business Days of the first day of work for pay, documentation establishing identity and authorization to work. You alone choose which document or combination of documents to present from the Lists of Acceptable Documents; no particular document is specified or demanded, and documents that reasonably appear to be genuine and to relate to you are not refused.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ac8a3c33-d784-4b80-869b-54cc7f16b658","order":71,"text":"The Employer participates in E-Verify and will provide to the Social Security Administration and, where necessary, to the Department of Homeland Security the information taken from the Form I-9 of each newly hired employee in order to confirm authorization to work. E-Verify is not used to pre-screen applicants, is not used selectively, and no adverse action is taken on the basis of a tentative nonconfirmation before the employee has been notified and given the opportunity to contest it. The federal notices \"Right to Work\" and \"E-Verify Participation\" are posted at the place of work.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"01f57d4b-d8dc-447a-bbc2-ab57f50787fc","value":"yes","type":"add","operator":"="}]},{"id":"6934be1c-2766-4685-ae8c-714d3960d500","order":72,"text":"7. EDUCATION AND TRAINING","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S07"},{"id":"d05c3127-3c2f-4f55-be5b-d8edba723637","order":73,"text":"List the institutions you have attended, beginning with the most recent. You are not required to state dates of attendance or the year in which a degree was awarded, and that information is not considered.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5eabc44a-1fce-4989-9e85-a4362340fde7","order":74,"text":"Secondary school or equivalent — name and location: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"dd1079b4-9d32-4d03-a0c2-532dcff0200f","order":75,"text":"Diploma, certificate or equivalent credential obtained: Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"238102ba-a1d5-4c1a-81a7-76815a12e289","order":76,"text":"College, university or graduate school — name and location: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"013bcd9f-03dc-4f2d-acb5-58747bc0998f","order":77,"text":"Course of study: ____________________________ Degree or credential obtained: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"a9ca0078-dcd2-4a18-b7a7-9d6a945c6104","order":78,"text":"Further college, university or graduate school — name and location: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"392f373a-db1f-4462-b5d5-4bab6f6a9633","order":79,"text":"Course of study: ____________________________ Degree or credential obtained: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"fd9cf877-426d-4802-93fd-9093280d9f5f","order":80,"text":"Vocational, technical, apprenticeship or military training relevant to the position: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"0c759b84-667b-4b8b-9cb8-a47c8ef5cd4b","order":81,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"eda975d9-f49a-4632-b20e-dde2c95099ee","order":82,"text":"8. PROFESSIONAL LICENSES, CERTIFICATIONS AND REGISTRATIONS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}],"sectionNum":"S08"},{"id":"5b8a6d69-dcb8-41a7-90d5-ae496ba83365","order":83,"text":"The position requires one or more professional licenses, certifications or registrations. List each license, certification or registration you hold that is relevant to the position.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"cc433a5c-c86d-4cf6-842d-d1e775ff6a3b","order":84,"text":"License, certification or registration: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"77a48787-0043-4278-98bf-f153efd7edb4","order":85,"text":"Issuing authority and state of issue: ____________________________ Number: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"37517490-0775-4076-8765-1ef41535e2d7","order":86,"text":"Expiration date: ____________________________ Current status (active, inactive, lapsed or restricted): ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"a2985341-d755-4788-adc4-0db196edf007","order":87,"text":"Further license, certification or registration: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"ddf9d14d-dc1e-4264-a598-d725cbe54783","order":88,"text":"Issuing authority and state of issue: ____________________________ Number: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"b7ade90b-4617-450d-a947-b34f79b63f9d","order":89,"text":"Has any professional license, certification or registration held by you ever been refused, suspended, revoked, restricted or made the subject of disciplinary proceedings? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"f63454b4-90a4-40b6-a269-ac39d21eb9cb","order":90,"text":"If yes, state the authority, the date and the outcome: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"d8b3423a-fd7e-4aa4-b466-3d26e2932714","order":91,"text":"Any offer of employment is conditional upon verification that each required license, certification or registration is valid and in good standing at the date of hire and upon its remaining so throughout the employment.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"c0e51df3-9a79-4fe0-8429-f8f0c65b88f1","value":"yes","type":"add","operator":"="}]},{"id":"b0cff9b4-8e70-48b4-a039-4a2328575d75","order":92,"text":"9. DRIVING RECORD","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}],"sectionNum":"S09"},{"id":"f3a98ae9-c79b-423b-b5c4-8f0101350c38","order":93,"text":"Driving is an essential function of this position. The following questions are asked only because of that requirement.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"debfaaac-8251-452e-9786-031c1ac76935","order":94,"text":"Do you hold a current and valid driver's license? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"1af71c74-696b-4df3-b5fa-2904a0b7f20d","order":95,"text":"State of issue: ____________________________ Class and endorsements: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"aa9a8638-6456-487f-8a3b-fa929e51c8aa","order":96,"text":"Expiration date: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"4a1b92a1-72b5-4456-b75f-5b94197fba53","order":97,"text":"Are you able to meet the driving requirements of the position, with or without a reasonable accommodation? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"b2fa972f-2d3d-401a-a8b1-8795e629edc9","order":98,"text":"If you would use your own vehicle for the position, do you maintain automobile liability insurance meeting at least the minimum limits required by law? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"c057a1ec-0b54-4635-b061-faa55d861367","order":99,"text":"Any offer of employment is conditional upon a review of your motor vehicle record. That record is obtained only after a Conditional Offer has been made and, where it is procured from a consumer reporting agency, only upon a separate written disclosure and your written authorization as required by the Fair Credit Reporting Act and by applicable state law. Do not state on this application any traffic matter that has been sealed, expunged or dismissed.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"4a4a5fa5-e148-4271-9185-dba47291e23c","value":"yes","type":"add","operator":"="}]},{"id":"3bffc040-ccb3-4505-bfb9-cd04ead08094","order":100,"text":"10. EMPLOYMENT HISTORY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S10"},{"id":"e23f2008-fb98-4ecd-b371-fd4b2846a7dd","order":101,"text":"Give your employment for the last [Number] years, beginning with your current or most recent position, including self-employment, military service and periods of temporary or agency work. Account for any period during which you were not employed. Attach a further sheet if the space provided is insufficient.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"6e7ada96-0dbe-4b0d-80ea-4ed0be082e03","order":102,"text":"MOST RECENT EMPLOYER","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"eabb4628-3850-4f52-9b94-3417e4d75e78","order":103,"text":"Name of employer: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"f0274602-b7d6-4768-970e-6d4429ae3938","order":104,"text":"Address: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"4b6670a9-de18-49d3-b984-fe9a7ef81e5c","order":105,"text":"Telephone: ____________________________ Your job title: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"a9708e86-c754-43e4-a718-41cc5e51b696","order":106,"text":"Dates of employment (month and year), from ____________________________ to ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"27f14ee7-9e3b-476c-9165-b2bfd4f62520","order":107,"text":"Name and title of your immediate supervisor: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"defebbd2-b2dd-4f86-97ba-c7bf7679b8df","order":108,"text":"Principal duties and responsibilities: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"ad04be5f-32dd-4cd5-af4a-9dbb14594972","order":109,"text":"Reason for leaving or for wishing to leave: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"3dcdb69d-7595-4120-a165-c767f73401f7","order":110,"text":"May your current or most recent employer be contacted? Yes ________ No ________ If no, state the reason: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"d8cac09f-0e76-414f-8c3d-bb06ac3e0164","order":111,"text":"PREVIOUS EMPLOYER","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"0a1ab364-489c-4f18-9e66-acae0f450c42","order":112,"text":"Name of employer: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"c69dd5f2-1977-4aed-a8d6-fa1bd4a795e3","order":113,"text":"Address: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"443d0045-3b8b-4d9a-b63c-e9c9b9588d71","order":114,"text":"Telephone: ____________________________ Your job title: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"f71c2678-0db4-4387-8961-b60ca0789e2f","order":115,"text":"Dates of employment (month and year), from ____________________________ to ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"c8a0ad57-2040-4ea9-97ba-e3e5bd6ee484","order":116,"text":"Name and title of your immediate supervisor: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"fe5ee388-4048-4afc-8ddc-9393f406cc02","order":117,"text":"Principal duties and responsibilities: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"872ef398-1333-4fdc-87d9-4dc084acc5fa","order":118,"text":"Reason for leaving: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"e98fa763-4068-4fac-b3b5-e66aefb653cf","order":119,"text":"May this past employer be contacted? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"1edf9deb-b09d-45b2-9098-9fd35f09e7e7","order":120,"text":"EARLIER EMPLOYER","fontSize":"14","textAlign":"left","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"bcb809b7-4b7b-4584-8b53-e4e7085a8b5f","order":121,"text":"Name of employer: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"d59658da-5cc6-4024-8ff6-8bb10e797807","order":122,"text":"Address: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"c9582fe3-fff9-4f34-a9a8-16a85520aa2a","order":123,"text":"Telephone: ____________________________ Your job title: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"980c9fd0-df2d-4eaf-acc0-d28306543c7f","order":124,"text":"Dates of employment (month and year), from ____________________________ to ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"883f9497-3a6e-47df-90d3-969b19653cfe","order":125,"text":"Name and title of your immediate supervisor: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"b4793010-fa3b-4d9b-833e-8bad1df23af6","order":126,"text":"Principal duties and responsibilities: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"70c87e78-f389-4139-ac37-f7e60819bf8a","order":127,"text":"Reason for leaving: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"a0b1d286-267b-4d31-89fc-6867f91af823","order":128,"text":"May this past employer be contacted? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"ceddb463-7e78-460e-b039-ee9477f88e13","order":129,"text":"Have you ever been discharged from employment, or asked to resign? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"66674f35-1273-4ecb-9ad7-897a6c6086c2","order":130,"text":"If yes, state the circumstances: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"8f95d186-d589-4b42-a21b-5e3cc79856bf","order":131,"text":"Periods within the years covered above that are not accounted for, with a brief explanation: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"512b7d1e-9d94-4346-acd0-d5fe1bae7a79","order":132,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"bb60a52d-9bd9-4538-85eb-ab0f1cf54aa8","order":133,"text":"11. SKILLS, QUALIFICATIONS AND FURTHER INFORMATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S11"},{"id":"37e273e4-de78-403b-8c96-d72229caca3b","order":134,"text":"Describe the skills, competencies and experience that qualify you for the position: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"917576a2-1cda-4227-91b6-251891930506","order":135,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3b0b81ee-0577-437a-9485-973bede86149","order":136,"text":"Software, systems, equipment or machinery you are able to operate proficiently: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"cc31b2fb-4b70-4fd1-9d3f-4fab0bbbe6db","order":137,"text":"Languages in which you are proficient, where relevant to the duties of the position: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"9c30c9fb-33dd-4d0e-b759-d803d3737dff","order":138,"text":"Professional or trade memberships and honors relevant to the position. Omit any organization the name of which would disclose a Protected Characteristic: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"42927b1e-fc72-4acb-9013-9843e11bbd85","order":139,"text":"Military service (voluntary). You may describe the branch in which you served, your occupational specialty and any training or experience relevant to this position: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"ae1293a3-0f6f-420d-9b59-5dc227412579","order":140,"text":"No question is asked about the character of your discharge, except where a particular position requires it by law or by contract.","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"431f5e70-3d58-4ee3-9b9b-1e7993526f50","order":141,"text":"12. CONFLICTS OF INTEREST AND EXISTING OBLIGATIONS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S12"},{"id":"c9bc7ee2-f7ff-486e-bcd3-27324777cabb","order":142,"text":"Existing agreements with a present or former employer. Are you subject to any agreement with a present or former employer or with any other person, including a covenant not to compete, a covenant not to solicit customers or employees, a confidentiality or non-disclosure agreement, an assignment of inventions, a training-cost repayment obligation or a garden-leave provision, which might restrict or otherwise affect your employment in this position? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"81477621-8b1a-4649-a6ae-360b3a5c82d2","order":143,"text":"If yes, identify each such agreement and attach a copy, or describe its terms and its duration: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"2f1139ca-17c9-4bcb-9820-ab34410fb5cf","order":144,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"2855cd88-79f3-445c-903e-736b247013ce","order":145,"text":"No account is taken of a covenant that is void, unenforceable or prohibited under the law of the State of [State] or under federal law, and a refusal to be bound by such a covenant is not a ground for refusing to consider your application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d095ecff-d0f5-446d-b680-9d469ad0fbcd","order":146,"text":"Confidential information belonging to others. You must not bring to the Employer, disclose to it, or use in the course of any employment with it, any trade secret, confidential information, proprietary material, customer list or document belonging to a present or former employer or to any other person, and you must not remove any such material from the possession of the person entitled to it. The Employer neither seeks nor wishes to receive any such information, and nothing in this application requires or invites you to disclose it. Any offer of employment is made on the basis that you are able to perform the duties of the position without breaching an obligation owed to another person.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f8976cc2-5bff-4550-9774-da11ee1b35d2","order":147,"text":"Relatives and close personal relationships. Is any relative of yours, or any person with whom you have a close personal relationship, employed by, or engaged as a contractor by, the Employer? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"21ace2f1-b74a-4fde-8713-210b04f2abab","order":148,"text":"If yes, give the name and the nature of the relationship. This information is used only in order to apply the conflict-of-interest and supervision policies of the Employer: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5d334371-5bb0-4e28-8a4e-4f9b92d50ec1","order":149,"text":"Other employment and outside interests. Do you hold, or do you intend to hold, any other employment, directorship, consultancy, public office or business interest which might conflict with the duties of this position or with the hours to be worked? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"e233cb82-3283-4217-a90e-e2bdec9914cb","order":150,"text":"If yes, describe it: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"8857044a-d33a-4c6f-b432-fac1cf7a4fd2","order":151,"text":"13. PROFESSIONAL REFERENCES","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S13"},{"id":"1be13cf6-8204-4f41-be59-8b6ecfe8e24f","order":152,"text":"Give three (3) professional references who are not related to you and who have direct knowledge of your work. You need not name a current supervisor if you do not wish that supervisor to be contacted before a Conditional Offer is made.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b280cb44-70aa-445e-883f-cf21e2b98588","order":153,"text":"First reference — name: ____________________________ Title and organization: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"8475d6e4-6e8c-4a54-a281-0b1344faa4a5","order":154,"text":"Relationship to you: ____________________________ Telephone: ____________________________ Email: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"d545687d-8ade-45cf-89ae-97e69e5a9600","order":155,"text":"Second reference — name: ____________________________ Title and organization: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"43269dd4-c6a1-4a94-ac66-3c6b9c608aa2","order":156,"text":"Relationship to you: ____________________________ Telephone: ____________________________ Email: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"855a60be-c5ec-42cb-b497-d5c13d12758a","order":157,"text":"Third reference — name: ____________________________ Title and organization: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"c98e94ae-25e1-4cb1-a4b2-6c24b1d16c6a","order":158,"text":"Relationship to you: ____________________________ Telephone: ____________________________ Email: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"4b17867c-578c-46c1-b7cf-f8a804c52a37","order":159,"text":"By naming a reference you authorize the Employer to contact that person in connection with your application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"2752ff52-83d6-4dac-97b5-0f8744191871","order":160,"text":"14. CRIMINAL HISTORY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S14"},{"id":"6b9f0b5a-3b23-40a6-a698-43490b08096a","order":161,"text":"No question concerning arrests, charges or convictions is asked on this application. Consistent with the fair-chance and so-called ban-the-box requirements of the State of [State] and of applicable local ordinance, any inquiry into criminal history, if it is made at all, is made only after a Conditional Offer has been extended.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"restricted","type":"add","operator":"="}]},{"id":"6fc5e02a-eac4-4ce9-9b13-23c11024dd4d","order":162,"text":"Do not disclose any criminal-history information on this application. Information volunteered here will be disregarded.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"restricted","type":"add","operator":"="}]},{"id":"63c33bb7-1d05-4cea-ab78-85574ea37486","order":163,"text":"If criminal-history information is later obtained, an individualized assessment is carried out in accordance with the enforcement guidance of the Equal Employment Opportunity Commission on the use of criminal records under Title VII and with applicable state and local law. That assessment takes into account the nature and gravity of the offense or conduct, the time that has elapsed since the offense or since the completion of the sentence, and the nature of the position sought. Before any adverse decision is taken you are given written notice of the record relied upon, a copy of the record, a reasonable period in which to respond and to submit evidence of rehabilitation, inaccuracy or mitigating circumstances, and written notice of the final decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"restricted","type":"add","operator":"="}]},{"id":"83b25e19-0ff3-49d9-9be5-97c4e5ebae31","order":164,"text":"Answer the following question exactly as it is written, and no more widely. You must not disclose, and no account is taken of: an arrest that did not result in a conviction; a record that has been sealed, expunged, dismissed, vacated, pardoned, annulled or otherwise eradicated; an adjudication of juvenile delinquency; participation in a diversion or deferred-adjudication program; a conviction for conduct that is no longer criminal under the law of the State of [State]; or an infraction or minor traffic matter.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"permitted","type":"add","operator":"="}]},{"id":"f2a6f43d-63fa-425f-aeb6-dc182e2cc7b4","order":165,"text":"Excluding all of the matters listed above, have you been convicted of a criminal offense within the last seven (7) years? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"permitted","type":"add","operator":"="}]},{"id":"68a57f67-6296-4d4b-b9b0-6f698f28e3c7","order":166,"text":"If yes, state the offense, the date and the disposition. You may also describe any circumstance you wish to be taken into account: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"permitted","type":"add","operator":"="}]},{"id":"d0ff8a9b-4028-42bb-8138-45d4a675643a","order":167,"text":"___________________________________________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"permitted","type":"add","operator":"="}]},{"id":"6736e526-21df-4378-a8cc-901f652649f3","order":168,"text":"A conviction does not automatically disqualify you from employment. An individualized assessment is carried out in accordance with the enforcement guidance of the Equal Employment Opportunity Commission on the use of criminal records under Title VII and with the law of the State of [State], taking into account the nature and gravity of the offense, the time that has elapsed and the nature of the position sought, together with any evidence of rehabilitation or mitigating circumstances that you provide. Before any adverse action is taken in whole or in part on the basis of criminal history, you are given written notice of the record relied upon and a reasonable opportunity to respond.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"392842c4-12b8-481d-8d7a-e5afcebdbec0","value":"permitted","type":"add","operator":"="}]},{"id":"a64e3b3e-a37e-4562-bc97-17b77d7a1fac","order":169,"text":"15. BACKGROUND AND REFERENCE VERIFICATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}],"sectionNum":"S15"},{"id":"a9399c23-9b4e-4f80-8ad9-5e1053d62322","order":170,"text":"Any offer of employment is conditional upon the satisfactory completion of the verification appropriate to the position. Verification is carried out after a Conditional Offer has been made and is applied consistently to all candidates for the same position.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"ea9585b9-a66e-447a-84d9-9e576c3b186c","order":171,"text":"Where a Consumer Report or an Investigative Consumer Report is obtained from a consumer reporting agency, you will first be given a clear and conspicuous written disclosure in a document that consists solely of that disclosure, and your written authorization will be obtained, as required by the Fair Credit Reporting Act and by applicable state law. That disclosure and authorization is a separate document and forms no part of this application. Any further notice, acknowledgment or consent required by the law of a particular state is given to you in a further separate document.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"16a73916-cb37-430a-8080-2f86015b2dba","order":172,"text":"Before any adverse action is taken in whole or in part on the basis of such a report, you will be given a copy of the report and a copy of the summary of consumer rights under the Fair Credit Reporting Act, together with a reasonable period in which to dispute the accuracy or the completeness of the information, followed by written notice of any final adverse action and of your right to obtain a further free copy of the report and to dispute its accuracy with the agency.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"c864f4d2-974a-4e61-bd70-83e53bec3307","order":173,"text":"Credit history is not obtained or considered unless the position falls within an exception permitted by the law of the State of [State] and the information is substantially related to the duties of the position.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"59938eaf-47b3-4cbe-9dd9-130d5be000fe","order":174,"text":"You authorize the Employer to verify the information given in this application, including your education, employment history, licenses and references, and you release from liability every person and organization that gives or receives such information in good faith, except to the extent that such a release is prohibited by law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"b49c9254-bf56-4618-bc58-d88abbd497d9","order":175,"text":"16. DRUG AND ALCOHOL TESTING","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"13a43f2c-6de6-4f87-befd-3b4283cffab1","value":"yes","type":"add","operator":"="}],"sectionNum":"S16"},{"id":"843d0a84-9c9d-4cbf-b86e-852422652767","order":176,"text":"A drug-free and alcohol-free workplace is maintained. Where it is permitted by the law of the State of [State] and by applicable local ordinance, any offer of employment is conditional upon your passing a pre-employment drug and alcohol test, administered after the Conditional Offer has been made and required of all candidates for the same position.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"13a43f2c-6de6-4f87-befd-3b4283cffab1","value":"yes","type":"add","operator":"="}]},{"id":"b31dee56-1596-4c73-93bf-e088e7cade8b","order":177,"text":"Testing is carried out by a licensed laboratory. A confirmed positive result is reviewed by a medical review officer, who will contact you before any result is reported and give you the opportunity to explain it, including by identifying any lawfully prescribed medication. No inquiry is made into your prescription medication, your medical history or any disability outside that process, and the results are kept in a file separate from your application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"13a43f2c-6de6-4f87-befd-3b4283cffab1","value":"yes","type":"add","operator":"="}]},{"id":"414b5879-cecd-4400-85cf-20d9c1997b4d","order":178,"text":"No adverse action is taken solely on the basis of lawful conduct away from work and outside working hours where the law of the State of [State] so provides, including, where applicable, the lawful off-duty use of cannabis or status as a registered patient under a medical-cannabis program. Nothing in this paragraph permits impairment at work or the possession, use or sale of any substance at the place of work, and nothing in it applies to a position governed by the drug-testing and alcohol-testing rules of the United States Department of Transportation or by any other federal statute, regulation or contractual requirement.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"13a43f2c-6de6-4f87-befd-3b4283cffab1","value":"yes","type":"add","operator":"="}]},{"id":"b2576077-a3a0-4ed3-a0eb-6f8c63795229","order":179,"text":"Are you able to comply with this policy? Yes ________ No ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"13a43f2c-6de6-4f87-befd-3b4283cffab1","value":"yes","type":"add","operator":"="}]},{"id":"a2707493-d252-49d8-96a3-ea1aeb0da5b6","order":180,"text":"17. SELECTION PROCEDURES, RECORDED INTERVIEWS AND AUTOMATED DECISION TOOLS","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}],"sectionNum":"S17"},{"id":"cfc3c8d6-e236-4a5b-b99a-3ad460b21457","order":181,"text":"Selection procedures. Every selection procedure used in connection with this position, including any test, work-sample exercise, assessment or structured interview, is job-related and consistent with business necessity, is administered uniformly to all candidates for the same position, and is scored and recorded consistently. A reasonable accommodation in the administration of any selection procedure is available on request, and a request for an accommodation is not taken into account in any employment decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}]},{"id":"01280ed0-a76f-4386-8e9f-72eeafa0f04d","order":182,"text":"Automated employment decision tools. An automated employment decision tool, which may include machine learning, statistical modeling or artificial intelligence, may be used to screen or to assess candidates for this position. Such a tool is used only as one element of the assessment; it does not itself determine the outcome, which is decided by a human being who reviews the assessment. No Protected Characteristic is used as an input to such a tool.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}]},{"id":"8a17a3e5-c1da-4504-88b0-02ce9b32748a","order":183,"text":"Where applicable law so requires, the tool has been the subject of an independent bias audit within the period prescribed, and a summary of the results of that audit, the date on which the tool began to be used, the job qualifications and characteristics that it assesses, the categories of data that it uses, the source of that data and the retention period applied to it, are published by the Employer or are supplied to you on request. You may request that your candidacy be assessed by an alternative process or that a reasonable accommodation be made, and no adverse inference is drawn from such a request.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}]},{"id":"ecca27d9-5f88-4237-a2c6-32e6790b6ce6","order":184,"text":"Recorded and video interviews. Where an interview is to be recorded, or where artificial intelligence is to be used to analyze a recorded interview, you will be informed before the interview takes place that the technology may be used, how it works and the general types of characteristics that it is used to evaluate, and your written consent will be obtained. Where facial-recognition or facial-analysis technology is to be used, a separate written consent is obtained. If you do not consent, an alternative process is offered and your application continues to be considered.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}]},{"id":"2d083c1f-3ec3-4381-9e96-7d5a5094d403","order":185,"text":"A recording is disclosed only to those persons whose expertise or technology is required in order to evaluate your candidacy. Upon your written request the Employer will destroy the recording, together with every copy of it and every backup copy, within thirty (30) days of the request, and will instruct every other person in possession of a copy to do the same.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"113c5cbc-5722-43bf-99d7-338bb5ff3c53","value":"yes","type":"add","operator":"="}]},{"id":"ee2821ac-dc3f-4a72-a102-2ada96e27c73","order":186,"text":"18. VOLUNTARY SELF-IDENTIFICATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}],"sectionNum":"S18"},{"id":"a85a393f-d02b-4343-b908-2a3b2bd5550f","order":187,"text":"[Company legal name] is a federal contractor or subcontractor and takes affirmative action to employ, and to advance in employment, qualified protected veterans under the Vietnam Era Veterans' Readjustment Assistance Act of 1974 and qualified individuals with disabilities under Section 503 of the Rehabilitation Act of 1973.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"44b97be0-93e6-445f-baa0-4df4ce4f53a6","order":188,"text":"Completing this section is entirely voluntary. Your answer, or your decision not to answer, is not considered in any employment decision, is kept confidential, and is held in a file separate from your application. This page is detached from the application before the application is seen by any person taking part in the selection decision. The information is used only for the record-keeping, reporting and civil-rights compliance purposes required of federal contractors.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"7816e876-0aa8-4c18-8102-13eb45718d29","order":189,"text":"Protected veteran status — check one: I identify as one or more of the classifications of a protected veteran ________; I am a veteran but not a protected veteran ________; I am not a protected veteran ________; I decline to identify ________.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"a6dfa0c2-c5bf-488c-af98-e8e0b7b15961","order":190,"text":"Disability status — check one: yes, I have a disability, or have had one in the past ________; no, I do not have and have not had a disability ________; I do not wish to answer ________.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"3ccd21d3-3713-4eb4-bafa-2c023aa62c5f","order":191,"text":"Gender, race and ethnicity. You are also invited, voluntarily, to identify your gender, race and ethnicity using the categories defined by the Equal Employment Opportunity Commission, for the purpose of the reports that the Employer is required to file. Gender: ____________________________ Race or ethnicity: ____________________________ I decline to identify ________.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"1c4b883e-057c-4a38-a87c-f3ca66ca9cb2","order":192,"text":"A refusal to give any of this information will not subject you to any adverse treatment, and the information will not be used in any way that is inconsistent with law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"bd0392f8-57d8-4ae7-8ac2-fad93fc7899c","value":"yes","type":"add","operator":"="}]},{"id":"b6f28039-1ee9-4aec-b948-95da4fd402a8","order":193,"text":"19. APPLICANT PRIVACY NOTICE","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}],"sectionNum":"S19"},{"id":"fc350fe7-7143-438f-9570-80531ca08244","order":194,"text":"This notice describes how the personal information you give in connection with your application is collected and used, and supplements any privacy policy published at [Company website or careers page].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"05f7a28b-c29c-4682-949d-2c4e6eb8542a","order":195,"text":"Categories collected. Identifiers and contact details; professional and employment history; education history; skills, licenses and qualifications; information required in order to verify eligibility to work; information you volunteer in support of your application; and, where lawful and only at the appropriate stage of the process, the results of any background verification or test. Sensitive personal information is collected only where the law requires or permits it and only for the purpose stated.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"baf56153-22fd-496a-b41f-dfae8eb5fda9","order":196,"text":"Purposes. Evaluating your application; communicating with you; verifying the information you have given; complying with legal obligations, including record-keeping and civil-rights reporting; maintaining the security and integrity of the recruitment process; and establishing, exercising or defending legal claims. Your personal information is not sold, and it is not shared for cross-context behavioral advertising. It is not used for automated decision-making producing legal or similarly significant effects without meaningful human review.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"dc3f97d9-04df-4264-b4fc-319684633188","order":197,"text":"Recipients. Personal information may be disclosed to service providers acting on documented instructions, to a consumer reporting agency where a verification is carried out, and to a public authority where the law requires it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"c75e702c-180f-44c9-9e7f-c648b34b7d49","order":198,"text":"Retention. Application records are retained for at least one (1) year from the date on which the application is received or from the date of any personnel action taken with respect to it, whichever is later, in accordance with the record-keeping regulations of the Equal Employment Opportunity Commission, and for longer where another law, a contract or a legal hold so requires.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"8bc05699-7057-4663-b270-f29d57ee75b7","order":199,"text":"Your rights. Depending upon the state in which you reside, you may have the right to know what personal information is held about you, to obtain access to it or a portable copy of it, to have it corrected or deleted, to limit the use of sensitive personal information, and to be free from retaliation for exercising any of those rights. To exercise a right, or to appeal a decision, contact [Contact for applicant requests].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"d783691c-bbbf-4b34-8df6-50f0e233e219","value":"yes","type":"add","operator":"="}]},{"id":"719c3538-7b9a-416f-b99d-542677ed2d96","order":200,"text":"20. COMMUNICATIONS AND CONSENT TO BE CONTACTED","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S20"},{"id":"ffecdfc9-d5a1-47a4-90a8-44769a80ee6c","order":201,"text":"Consent to be contacted. By giving a telephone number or an email address in this application you consent to being contacted at that number or at that address in connection with your application and with any future vacancy for which you may be considered, including by voice call, by voicemail, by email and by text message, and including by means of an automatic telephone dialing system or a prerecorded voice.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"ac560cc1-26f9-4869-9c03-81adf43c989f","order":202,"text":"Withdrawal of consent. You may withdraw that consent at any time, wholly or in part, by notifying [Contact for applicant requests], or by replying STOP to a text message. Withdrawal of consent has no effect whatever upon the consideration of your application. Consent is not a condition of employment or of consideration for employment. Message and data rates may be applied by your carrier.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"5f31c2b1-7894-4ccf-bf03-94ea1f29c503","order":203,"text":"Change of details. While your application remains active you should inform the Employer promptly of any change in your address, telephone number or email address. A communication sent to the address or to the number last given by you is treated as having been received by you.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"c04b03ba-76e9-4247-9d0f-50b06ed5ed9b","order":204,"text":"Language. If you require this application, or any communication relating to it, in a language other than English or in an accessible format, ask the accommodation contact named at the beginning of this application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"5d7d2eec-b343-4924-b9ed-063e82056fbf","order":205,"text":"21. NOTICE CONCERNING ARBITRATION OF EMPLOYMENT DISPUTES","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"9f192bc6-efb1-46c9-8f50-f03c21bdaccc","value":"yes","type":"add","operator":"="}],"sectionNum":"S21"},{"id":"f73a6e55-562d-4867-9936-ebffb5a10f00","order":206,"text":"This notice is given for your information only. Signing this application does not create an agreement to arbitrate and does not waive any right. If you are offered employment you will be asked to consider a separate mutual arbitration agreement, which will be given to you as a separate document and which you will have a reasonable opportunity to read, and to take advice upon, before deciding whether to sign it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9f192bc6-efb1-46c9-8f50-f03c21bdaccc","value":"yes","type":"add","operator":"="}]},{"id":"a6625f09-9e8c-4446-ad6b-db99de582923","order":207,"text":"Under that agreement, the Employer and the employee would each submit covered employment claims to final and binding arbitration before a single neutral arbitrator, administered under the employment rules of a recognized arbitration provider, the Employer bearing the costs that are unique to arbitration. The arbitrator would apply the same substantive law and award the same remedies as a court, and would issue a reasoned written award.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9f192bc6-efb1-46c9-8f50-f03c21bdaccc","value":"yes","type":"add","operator":"="}]},{"id":"a85f78ac-e4ba-4537-861b-dd29e1aec04f","order":208,"text":"Claims that may not lawfully be made the subject of a pre-dispute arbitration agreement are excluded, including a claim of sexual assault or sexual harassment within the meaning of the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021, a claim for workers' compensation or unemployment benefits, and any claim that a statute reserves to a court. Nothing in the agreement prevents you from filing a charge or complaint with, or taking part in an investigation or proceeding before, the Equal Employment Opportunity Commission, the National Labor Relations Board, the Department of Labor or any other administrative agency, or from recovering any relief awarded by such an agency.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"9f192bc6-efb1-46c9-8f50-f03c21bdaccc","value":"yes","type":"add","operator":"="}]},{"id":"fe8e6d95-3115-4f4e-9410-2973648590e7","order":209,"text":"Where the law of the State of [State] prohibits requiring an arbitration agreement as a condition of employment, the agreement is offered on a genuinely voluntary basis, and neither a refusal to sign it nor a request for time to consider it will affect the consideration of your application or the terms of any offer.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"9f192bc6-efb1-46c9-8f50-f03c21bdaccc","value":"yes","type":"add","operator":"="}]},{"id":"fa6a8e29-6d31-4145-84dc-bfa92c16907c","order":210,"text":"22. CERTIFICATION, AUTHORIZATION AND ACKNOWLEDGMENT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S22"},{"id":"031b7e16-d58b-4f52-931c-db619f55d2b7","order":211,"text":"Read the following statements carefully before signing. By signing below you confirm each of them.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"54a910d0-5ca7-42ad-bee0-7c46315f6fed","order":212,"text":"Accuracy. I certify that the statements made in this application, and in any document or interview given in support of it, are true and complete. I understand that a false statement, an omission or a misrepresentation of a material fact is a ground for refusing to hire me or, if it is discovered after I have been employed, for terminating my employment immediately, whenever it may be discovered.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"bdf9c2b8-cd92-4f76-8116-2f2c94db45e0","order":213,"text":"Authorization to verify. I authorize [Company legal name] to investigate and to verify the information contained in this application, including my education, my employment history, my licenses and my references, and I authorize the persons and organizations named to release information concerning me. I release those persons and organizations, and the Employer, from all claims and liability arising out of the giving or the receiving of such information in good faith, except to the extent that such a release is prohibited by law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"477c8c1e-f8db-4125-b813-c9bd7d431997","order":214,"text":"Conditional Offer. I understand that any offer of employment is conditional upon the satisfactory completion of every pre-employment requirement that applies to the position, including verification of my identity and of my authorization to work in the United States, and that each such requirement is applied consistently to all candidates for the same position.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"994b6814-a74a-411c-9e3f-049bafa25113","order":215,"text":"Employment at will. I understand and agree that, if I am employed, my employment is at will, which means that either I or [Company legal name] may end the employment relationship at any time, with or without cause and with or without notice. I understand that neither this application, nor any handbook, policy, practice or statement made during the selection process, creates a contract of employment or a promise of employment for any fixed term, that this application is not a contract, and that only an authorized officer of the Employer may alter the at-will relationship, and then only by a written agreement signed by that officer. This paragraph does not apply to the extent that employment is governed by a collective bargaining agreement, or to the extent that the law of the State of [State] provides otherwise, and it does not limit any right that may not lawfully be waived.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"45b511be-abb6-4a32-9173-3614bfa44d1f","order":216,"text":"Rights that are preserved. Nothing in this application prevents me from discussing wages, hours or working conditions with other employees or with a labor organization, from filing a charge or complaint with any federal, state or local agency or taking part in its investigation, from reporting conduct that I reasonably believe to be unlawful, or from exercising any other right that may not lawfully be waived.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"8fd63fb0-cb49-4a46-ba9d-c5579dffc7e3","order":217,"text":"Equal opportunity. I understand that the Employer is an equal opportunity employer, that no information concerning any Protected Characteristic has been requested from me, and that any such information I may have volunteered will not be considered in any employment decision.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0b57d1e8-b1b6-46a8-b6a3-c448937f0cda","order":218,"text":"Electronic signature. I agree that a signature given by electronic means has the same force and effect as a handwritten signature, in accordance with the Electronic Signatures in Global and National Commerce Act and with applicable state law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"45aa16ed-6f0e-4f7e-8ad7-ed344c8f61f8","order":219,"text":"Severability. If any part of this certification is held to be invalid or unenforceable, that part is treated as modified to the least extent necessary to make it enforceable, or, if it cannot be so modified, as severed, and the remainder of the certification continues in full force and effect.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f224c746-89c4-4777-b886-f80a41c06fc7","order":220,"text":"No waiver. A failure or a delay by the Employer in insisting upon any requirement of this application is not a waiver of that requirement or of any other requirement.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"06d7eef8-a868-462c-b3af-1dfd5096cd15","order":221,"text":"Governing law. This application, and the certification given in it, are governed by and construed in accordance with the law of the State of [State], without regard to its rules on conflict of laws, and without prejudice to any right conferred by federal law or by the law of any other jurisdiction which may not lawfully be waived.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7220d643-fbcb-4561-a6f6-b7dddc8d21c9","order":222,"text":"Copy of the application. I may ask for a copy of this application, once it has been signed, and a copy will be provided to me without charge.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true},{"id":"78546684-92c6-4bc5-8570-5baf5f14a8b5","order":223,"text":"23. SIGNATURE OF THE APPLICANT","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S23"},{"id":"80ea45f9-a559-4fd4-ade6-6789d2056497","order":224,"text":"Do not sign until you have read the certification set out above and are satisfied that this application is complete and accurate.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true},{"id":"e359a4d7-6328-40cc-8a74-3eb37b5319f6","order":225,"text":"Signature of the applicant: _______________________________________________ Date: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f67681af-ca6a-478f-9b73-1fa591bf95ad","order":226,"text":"Printed name: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"1e26d8a1-5194-4b2a-9581-d6c5817c465c","order":227,"text":"Signature of a parent or guardian, where the applicant is under eighteen (18) years of age: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"3c46de78-1c79-43e2-b075-7b09415fcc12","order":228,"text":"Annex A (disclosure and authorization regarding consumer reports) accompanies this application. It is a separate document, it is signed separately, and it forms no part of this application.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"24","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"28e532a5-6644-4337-9edb-377b10d16f79","order":229,"text":"ANNEX A","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true,"marginTop":"30","displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"f60426b2-961e-487f-91c2-d77850971940","order":230,"text":"DISCLOSURE REGARDING BACKGROUND INVESTIGATION","fontSize":"16","textAlign":"center","bold":true,"underline":true,"marginBottom":"16","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"6833b792-11f6-4491-9add-f72cdbab848e","order":231,"text":"[Company legal name] may obtain information about you from a consumer reporting agency for employment purposes. You may therefore be the subject of a Consumer Report or of an Investigative Consumer Report. That report may contain information concerning your character, your general reputation, your personal characteristics and your mode of living, and may include verification of your education, of your employment history and of your professional licenses, together with criminal history records, motor vehicle records and interviews with persons who have knowledge of you. Such a report may be obtained at any time after your authorization has been received and, if you are employed, at any time during your employment to the extent permitted by law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"369ade4c-cd96-491c-b5cf-e7f5fc6722bc","order":232,"text":"AUTHORIZATION","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"66fd1349-e898-4735-8623-6c854ff2d57a","order":233,"text":"I have read and I understand the disclosure set out above. I authorize [Company legal name], and any consumer reporting agency engaged by it, to obtain the reports described in that disclosure and to furnish them to it. I understand that I may request a copy of any report obtained about me, and that I may dispute the accuracy or the completeness of any information contained in it with the agency that furnished it.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"12","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"f75d3589-f674-40fa-a8ef-60c73cc8be0f","order":234,"text":"Check here if you wish to receive a copy of any Consumer Report or Investigative Consumer Report obtained about you: ________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"14","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"e7b1e205-34f0-426b-8870-2dcb523b76e4","order":235,"text":"Full legal name: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"8","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"691db860-c05c-4a41-8fe4-9d3e0e249f63","order":236,"text":"Signature: _______________________________________________ Date: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"26","cflou":false,"active":true,"displayConditions":[{"field":"45e6f465-740c-4bc1-9432-5f47dc1268b0","value":"yes","type":"add","operator":"="}]},{"id":"af422d2a-58a4-4c67-adc1-74f8154c101f","order":237,"text":"24. FOR EMPLOYER USE ONLY","fontSize":"16","textAlign":"left","bold":true,"underline":true,"marginBottom":"12","cflou":false,"active":true,"marginTop":"10","sectionNum":"S24"},{"id":"21ce7e79-6f8a-4aee-adb0-a18475fd5d8a","order":238,"text":"Applicants must not complete this section.","fontSize":"12","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"40f11812-8701-4286-a5b0-22e76b4b1038","order":239,"text":"Requisition: [Requisition number] Date the application was received: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"64798f20-325c-44fc-8564-d2b6fc83a3d5","order":240,"text":"Received by: ____________________________ Source of the application: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"ce6673e9-092a-4e13-8432-abba541510e4","order":241,"text":"Interview dates: ____________________________ Interviewers: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"ae00dd3c-24e3-406b-94a9-b3f7e97fbc81","order":242,"text":"Disposition: ____________________________ Date of the disposition: ____________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"88d07447-8171-4799-957c-e4eef8e8cfd7","order":243,"text":"Job-related and non-discriminatory reason for the disposition: _______________________________________________","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"475df73b-a940-4e09-a946-b67af0210633","order":244,"text":"Retention. This application and every record made in connection with it are retained for at least one (1) year from the date on which the application was received, or from the date of the personnel action taken with respect to it, whichever is later, in accordance with the record-keeping regulations of the Equal Employment Opportunity Commission, and for at least two (2) years where the Employer is a federal contractor to which the longer period applies. Where a charge of discrimination or an action has been brought, the records are retained until the final disposition of that charge or action.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"0d09aa65-773d-4ddb-883c-cdb986f2141d","order":245,"text":"Self-identification information, information relating to a medical condition or a disability, the results of any test, and any Consumer Report are held in files separate from this application and are disclosed only to those persons who need them for a lawful purpose.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true}]