TO THE APPLICANT PRESENT ADDRESS CITY IF YES, WHEN?______________________________ POSITION HELD_____________________________ IF YOU ARE ACQUAINTED WITH OR RELATED TO ANY CALDWELL TANKS, INC. EMPLOYEE OR DIRECTOR, PLEASE INDICATE NAME AND RELATIONSHIP. _______________________________________________________________________________________________________________ The Federal Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990 prohibit discrimination in employment practices because of race, color, religion, sex, disability, or national origin.
The Federal Age Discrimination in Employment A ct of 1968 and State laws further prohibit discrimination on the basis of age with respect to individuals who are at least 40 years o f age. It is the olic of Caldwell Tanks, Inc. to observe these laws.
Please answer all questions on this form to the best of your ability so that your qualifications may be carefully reviewed and given thorough consideration. No question on this application is intended to secure information to be used for the purposes of discriminating. CONFIDENTIAL APPLICATION FOR EMPLOYMENT PLEASE PRINT IN INK ZIP SOCIAL SECURITY # HOME ( ) - CELL ( ) - WORK ( ) - STREET STATE NAME LAST FIRST MIDDLE YES OR NO COMPLETED GPA LAST YEAR GRADUATED POSITION OBJECTIVE POSITION APPLIED FOR SALARY EXPECTED START DATE SHIFTS ARE YOU LEGALLY ... more. less.
ABLE TO WORK IN THE UNITED STATES?<br><br> YES______ NO______ HAVE YOU PREVIOUSLY APPLIED FOR A POSITION 1ST____2ND____3RD____ $___________/Yearly OR WORKED FOR CALDWELL TANKS, INC.? YES_____ NO_____ FULL TIME _______ PART TIME _______ PERSONAL FROM: TO: HIGH SCHOOL OR PREPARATORY EDUCATION (List Name of Last School/Institution Attended for Each Category) DEGREE NAME, ADDRESS, CITY, STATE, AND ZIP MAJOR COURSE OR SUBJECT COLLEGE BUSINESS / VOCATIONAL / OTHER 6/6/2008 FROM: TO: MO/YR MO/YR AREA CODE & PHONE # FROM: TO: MO/YR MO/YR FROM: TO: MO/YR MO/YR STARTING POSITION ENDING POSITION $_____________/ HR.______ MO______ $_____________/ HR.______ MO______ STARTING SALARY: ENDING SALARY: ENDING POSITION DUTIES REASON FOR SEEKING NEW EMPLOYMENT NAME AND TITLE OF SUPERVISOR OR MANAGER ADDRESS (INCLUDING CITY, STATE, ZIP) EMPLOYMENT EXPERIENCE (List All Full Time and Part Time Employment; List Recent First) STARTING SALARY: ENDING SALARY: $_____________/ HR.______ MO______ $_____________/ HR.______ MO______ AREA CODE & PHONE # EMPLOYED STARTING POSITION FIRM'S NAME NAME AND TITLE OF SUPERVISOR OR MANAGER DUTIES EMPLOYED FIRM'S NAME ADDRESS (INCLUDING CITY, STATE, ZIP) EMPLOYED FIRM'S NAME AREA CODE & PHONE # REASON FOR SEEKING NEW EMPLOYMENT ENDING POSITION NAME AND TITLE OF SUPERVISOR OR MANAGER REASON FOR SEEKING NEW EMPLOYMENT DUTIES ADDRESS (INCLUDING CITY, STATE, ZIP) $_____________/ HR.______ MO______ $_____________/ HR.______ MO______ ENDING SALARY: STARTING SALARY: STARTING POSITION 6/6/2008 PURCHASING SAFETY LOSS CONTROL CONTRACT ADMINISTRATION PROJECT MANAGEMENT STEEL FABRICATION WELDING PAINTING SUPERVISION / MANAGERIAL EXPERIENCE FIELD CONSTRUCTION ESTIMATING / SALES BLUEPRINT INTERPRETATION OTHER ____________________________________________ OTHER ____________________________________________ HAVE YOU EVER BEEN CONVICTED OF OR PLEADED GUILTY (INCLUDING AN ALFORD PLEA or NOLO CONTENDERE) TO A FELONY? YES______ NO______ (IF YES, GIVE DATE, PLACE, AND CIRCUMSTANCES) NOTE: CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FROM FURTHER CONSIDERATION FOR EMPLOYMENT.<br><br> PC-BASED SPREADSHEET SOFTWARE ENGINEERING only if you are applying for truck driver position.) VALID DRIVER'S LICENSE (Please check CAD-CAM DRAFTING PROGRAMMING ACCOUNTING PC-BASED ACCOUNTING SOFTWARE SHORTHAND______ W.P.M. PC-BASED WORD PROCESSING SOFTWARE PERSONAL COMPUTER DICTAPHONE WHY ARE YOU INTERESTED IN EMPLOYMENT WITH CALDWELL TANKS? MILITARY SERVICE RECORD INDICATE EXPERIENCE / SKILLS / OR EQUIPMENT KNOWLEDGE (Tests May be Administered for Proof) HAVE YOU SERVED IN THE ARMED FORCES OF THE UNITED STATES?<br><br> YES______ NO______ TYPING_______ W.P.M. WERE YOU DISCHARGED FROM THE ARMED SERVICES UNDER HONORABLE CONDITIONS? YES______ NO______ 6/6/2008 LIST THREE PERSONAL REFERENCES WHO ARE NOT RELATIVES OR FORMER EMPLOYERS NAME NAME NAME ADDRESS ADDRESS ADDRESS PHONE NUMBER PHONE NUMBER PHONE NUMBER OCCUPATION: OCCUPATION: OCCUPATION: STATEMENT (Please read carefully) DATE APPLICANT'S SIGNATURE (Full Name) INTERVIEWER(S) DATE OF INTERVIEW COMMENTS TENTATIVE ACTION TAKEN FINAL ACTION TAKEN CT-218 PERSONAL REFERENCES DO NOT WRITE BELOW THIS SPACE (City, State & Zip) (City, State & Zip) (City, State & Zip) I hereby certify that the answers given and statements made are true and correct.<br><br> I understand that misrepresentation of the fa cts, or omitted or false statements on this application may result in immediate disqualification of this application or immediate di smissal after employment begins. I hereby authorize all my previous employers and references to furnish any information concerning my personal character or employment records. You may make investigation through credit and other investigating agencies, and I release persons making such inquiries from liability or damages incurred as a result of inquiry and furnishing this information .<br><br> I agree that the submission of this application to Caldwell Tanks, Inc. and its acceptance does not imply that there are any posi tions open and does not in any way obligate Caldwell Tanks, Inc. I understand and agree that if employed, my employment will be for n o fixed term and will be terminable at will by either party at any time with or without cause and without any previous notice fro m the employer.<br><br> If employed, I agree to comply with all rules of Caldwell Tanks, Inc. 6/6/2008 Caldwell Tanks, Inc. Supplemental Application Data Sheet Date Position Applied For Sex: Male Veteran Status: Female Other Protected Veteran* Vietnam-Era Veteran Disability Status Mentally Challenged Physically Challenged Armed Forcers Service Medal Veteran** ETHNICITY/RACE: How Did You Find Out About This Position: Newspaper or other Publication Word of Mouth State Employment Office Walk-in High School or College Career Office Other: Caldwell Tanks, Inc ., is a government contractor, and is required to submit periodic reports to the government on its job applicants.<br><br> Therefore, i n an effort to comply with applicable government regulations, and to ensure equality of employment opportunities to all individua ls, we are requesting that you assist us in our effort by providing us with the following information. This form will be used for statistical purposes only. Your submission of this information is optional.<br><br> Failure to provide this information will not affect our consideration of your appli cation for employment. This document will not become part of your employment application or personnel file in the event that you are hired. **A Veteran who, while serving on active duty in the Armed Forces, participated in a U.S.<br><br> Military operation for which an Armed Forces Service medal was awarded pursuant to Executive Order 12985. Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa. Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South/Central American, or other Spanish culture or origin, regardless of race.<br><br> White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East or North Africa Caldwell Tanks, Inc . is an Equal Opportunity Employer. We are committed to providing Equal Employment Opportunities to all persons.<br><br> Special Disabled Veteran Recently Separated Veteran - (Within the last three years) *A Veteran who served on active duty in the U.S. Military, ground, naval, or air service during a war or in a campaign or exped ition for which a campaign badge has been authorized. Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.<br><br> American Indian or Alaskan Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment. Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five race categories.<br><br> CTA-6 Revised 10/17/07 Excel/EEO/S107 I, Last Name First Name Middle Name (Please include Jr., Sr, II, III, Etc.) Signed Today's Date Name as it appears on your driver's licence Position applied for Social Security Number Date of Birth Driver's License Number State Current Address: Street Apt # City State Zip Code From/To Former Address: Street Apt # City State Zip Code From/To Former Address: Street Apt # City State Zip Code From/To Former Address: Street Apt # City State Zip Code From/To I agree, authoirze and consent to the procurement of a Consumer Report and/or investigative Consumer Report and understand that it may contain information about my creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. This authorization in orignal or copy form shall be valid for my term of work from the date indicated next to my signature. According to the Fair Credit Reporting Act, I will be notified by Caldwell Tanks, Inc.<br><br> if work is denied because of information obtained from a consumer reporting agency. Additionally, I understand that if requested within 60 days, I will be given a full and accurate disclosure as to the nature of the substance of all informatio n provided to Caldwell Tanks, Inc. I further understand that I amy request a copy of the report, and that while doing so, proper identification will re quired and I should direct my request to: AbsoluteHire, 3009 Douglas Blvd., 3rd Floor, Roseville, CA 956 61.<br><br> I understand that residents of all states will automatically recive a copy of the report if an aversive action is taken regardi ng the employment application, or upon request as outlined herein. AGREEMNT, AUTHORIZATION, AND CONSENT FOR RELEASE OF BACKGROUND INFORMATION Please Type or Print understand that in conjustion with my application for employments, work to be performed under contract, promotion, volunteer position, reassignment, and/or retention ("work"), Caldwell Tanks, Inc. will use the services of an outside agency to research and verify the information I have provided on my application for employment including my personal background, character, professional standing, work history and qualifications.<br><br> This agency will provide a written report of its findings to Caldwell T anks, Inc. Caldwell Tanks, Inc. uses AbsoluteHire, a consumer-reporting agency, as an agent to perform its Employment related AbsoluteHire will utilize various sources of information it deems appropriate including but not limited to: criminal conviction records, current and former employers, department or motor vehicles records, military records, credit reporting agencies, education records, professional and personal references and workers compensation records including any and all injuries in compliance with the Americans with Disabilties Act.<br><br> I agree, authorize and consent to the release and disclosure of any and all information including but not limited to the above to Caldwell Tanks, Inc and AbsoluteHire. Please Provide All Resedential Addresses for the Past Seven Years CHECK THIS BOX IF you are applying for work with a California, Minnesota, or Oklahoma based employers and you would like a copy of your Consumer Report if one is prepared in the investigation of your background. CA Codes 1785.20.5 & 1788.<br><br> 16(a)(5)(1). MN Code 13C Subdivion 2, OK Code 24 O.S. 148 LAW ENFORCEMENT AGENCIES AND OTHER ENTITIES FOR POSITIVE IDENTIFICATION PURPOSES REQUIRE THE FOLLOWING INFORMATION WHEN CHECKING PUBLIC RECORDS.<br><br> IT IS CONFIDENTIAL AND WILL NOT BE USED FOR ANY OTHER PURPOSES. PLEASE PRINT CLEARLY . Other names you have used, or are also known as, including maiden name, name changes or any aliases: 6/6/2008 EEO-25 You are hereby notified that a consumer report or an investigative consumer report may be obtained from a consumer reporting agency, other agency or directly by thisemployer for the purpose of evaluating you for employment, promotion, reassignment or retention as an employee.<br><br> The report may contain information bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living from public or private record sources or through personal interviews with your neighbors, friends, associates or education facility. CALDWELL TANKS, INC. 4000 Tower Rd., Louisville, KY 40219 57 E.<br><br> Broad Str., Newnan, GA 30263 Consumer Reports Notification