Operator Employment Eagle Excavation Application General InformationApplication Date* MM slash DD slash YYYY Name* Email* Phone*Address* City* State* Zip* Confirm Position of Interest* Laborer Carpenter Operator Work Sought?* Part-time Full-time Other Are you 18 years or older?* Yes No Are you authorized to work in the U.S.?* Yes No Have you been previously employed here? Yes No Have you filed an application before? Yes No Friends or relatives that work at Eagle Excavation? Who? Method of transportation? Salary Desired Date available to work? Work HistoryMost Recent Employer PhoneEmployer AddressJob DutiesReason for LeavingStarting and Ending Salary Employer 2 PhoneEmployer AddressJob DutiesReason for LeavingStarting and Ending Salary Employer 3 PhoneEmployer AddressJob DutiesReason for LeavingStarting and Ending Salary EducationHigh School* Name of High School and CityDegree or DiplomaDegreeDiplomaGEDCollege College and City, StateYears CompletedOneTwoThreeFourMoreDegree or DiplomaDegreeDiplomaGEDCourse of Study List of Certifications or Special TrainingReference One* Relationship Phone*Reference Two* Relationship Phone*Reference Three* Relationship Phone*Additional InformationDriver's Lisence Number* Person of contact in case of emergency:* Phone*Authorization and UnderstandingPlease read below* Yes, I understand and agree. Upon signing this application, I verify all the information provided is true. I authorize Eagle Excavation to verify the information provided by me is true with the appropriate agencies, individuals, companies or institutions. I authorize them to release required information to Eagle Excavation, including my prior disciplinary employment without an obligation to me of written disclosure or notice. I also authorize Eagle Excavation to provide information requested by prospective or subsequent employers without an obligation to me of written disclosure or notice. I hereby release Eagle Excavation of any liability whatsoever of such inquiries or disclosures and this release of liability does not wave or prohibit individual from filing a charge of discrimination under the laws enforced by the EEOC. I agree any false information in support of my application may subject me to discharge at any time during my employment with Eagle Excavation. I agree that either party may terminate employment relationship, with or without cause, at any time, and I further agree this agreement may be altered in writing directed to me personally and signed by the president of Eagle Excavation. I agree that I shall be bound by the rules, policies, terms and conditions of employment with Eagle Excavation. These terms may be altered from time to time and no additional obligations can be imposed on Eagle Excavation except those which have been acknowledged in writing by the president or his designated representatives. I agree that action taken against Eagle Excavation, its agents or employees, arising out of employment or termination of employment, including but not limited to claims arising under State or Federal law but not Federal civil rights statues containing a separate limitations period. Must be brought within 180 days of event giving rising to claims or forever be barred unless the applicable statue of limitations period is shorter than 180 days in which case I will be bound by the shorter limitations period. I waive any limitation periods to the contrary. I further agree that if I bring any non-statutory actions or claims arising out of my employment against Eagle Excavation, in which Eagle Excavation prevails, I will pay Eagle Excavation any and all such costs incurred by Eagle Excavation in defense of said claims actions, including attorney fees. I further agree my employment is conditional until such time as my post offer physical (if physical required) is known.Equal Employment Opportunity QuestionnaireEagle Excavation is is in full compliance with federal, state, local laws and with Executive Order 11246, as amended, is committed to the continual evaluation of our Affirmative Action Program (AAP). It is unlawful employment practice for an employer to fail or refuse to hire or discharge any individual, or otherwise discriminate against an individual with respect to the individual's terms and conditions of employment, because of an individual's race, color, religion, sex, national origin, gender identity, disability, or veteran status. In order to evaluate our progress as an Equal Opportunity Employer, we are asking all applicants to please complete this questionnaire. Information pertaining to sex and race/ethnic heritage is requested and voluntary. Information pertaining to veteran status is voluntary and will NOT subject you to any adverse treatment. **If you choose not to self identify your race/heritage, the federal government requires the employer to determine this information by visual survey or other available information. Confidential Applicant Information Female Male I prefer not to answer Race/Heritage Hispanic or Latino White (Caucasian) Black (African American Non-Hispanic) Native Hawaiian or other Pacific Islander Asian American Indian or Alaskan Native Two or more races Other Are you in the Armed Forces or State National Guard? Yes No I prefer not to answer Reasonable Accommodation Notice Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or perform your job. Examples of reasonable accommodation include making a change to to the application process or work procedures, providing documents in an alternate format, using sign language interpreter or using specialized equipment. Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about five minutes to complete. Voluntary Self-Identification of DisabilityEagle Excavation does business with the government, we must reach out to hire and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to voluntarily tell us if you have or have ever had a disability. This information will NOT be used against you in anyway. If you already work for Eagle Excavation, your answer will NOT be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without having fear of any punishment because you did not identify as having a disability earlier. Criminal Record Check Policy1. This policy only reviews convictions. Arrest records will not be checked. 2. No applicant will be hired who has any conviction or incarceration for any crime of dishonesty, drug possession or sales, or assault, or aggression within seven years before applying at Eagle Excavation. 3. No applicant will be hired for any position involving driving who has a conviction of a driving offense involving alcohol or drug use within three years prior to applying at Eagle Excavation. 4. All other applicants with convictions within seven years of application will be reviewed by Eagle Excavation to determine whether the conviction disqualifies the applicant. Eagle Excavation will also review driving records and may reject applicants because of poor driving records. 5. Any applicants who falsify employment applications by indicating they have no convictions when they indeed have been convicted in the past will not be hired and, if hired before conviction search is completed, will be terminated when the search record confirming a conviction is received by Eagle Excavation. 6. Any employee who is convicted for any reason during their employment must inform Eagle Excavation, in writing of the conviction within five business days of the conviction. Failure to timely provide written notification to Eagle Excavation of the conviction will result in the immediate termination of the employee. The employment status of an employee who timely reports a conviction will be reviewed on a case-by-case basis. Eagle Excavation may, in its discretion and as allowed by law, also conduct random and/or periodic criminal records checks of existing employees for convictions. 7. Appropriate steps will be taken to maintain the confidentiality of information received regarding an applicant's or employee's criminal record. Criminal conviction records will be maintained by the Human Resources Department in a file in an appropriate restricted envelope secured for restricted access. 8. Nothing in this policy shall be modify EagleExcavation's employment policies. Have you ever been convicted of a felony?* Yes No If yes, please explainBy checking this box, I represent that this information now or hereafter given by me in support of this application is true.* Yes, this information given is correct CAPTCHAEmailThis field is for validation purposes and should be left unchanged.