ARE YOU 18 YEARS OR OLDER?
Are you available to work weekends?
IF SO, may we contact your current employer?
Are you available to work overtime?
IF HIRED, Can you present evidence of your legal right to work in the U.S.?
IF HIRED, Would you have a reliable means of transportation to and from work?
WHO REFERRED YOU TO THIS COMPANY?
PERFORMANCE OF ESSENTIAL JOB FUNCTIONS
Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation? (If no, describe the functions that cannot be performed.)
LIST ALL YOUR EMPLOYERS OVER THE PAST 7 YEARS, STARTING WITH THE MOST RECENT.
PROVIDE THREE (3) PROFESSIONAL REFERENCES, NOT RELATED TO YOU, WHO HAVE KNOWN YOU FOR AT LEAST ONE (1) YEAR.
AUTHORIZATIONS − Read and initial each paragraph, then sign below:
TRUTHFULNESS OF APPLICATION: I hereby certify that I have not knowingly withheld any information that might adversely
affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I
further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or
misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection
of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
HONESTY: I certify that I have never intentionally submitted false documents, filed a fraudulent workers’ compensation claim,
or purposefully deceived an employer and that I will not do so if employed by the Company
AUTHORIZATION TO INVESTIGATE: I hereby authorize Concord Environmental Energy, Inc. to thoroughly investigate my
references, work record, education and other matters related to my suitability for employment unless otherwise specified
above. I further authorize the references I have listed to disclose to the company any and all letters, reports and other
information related to my work records without giving me prior notice of such disclosure. In addition, I hereby release the
Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims,
demands or liabilities arising out of, or in any way related to, such investigation or disclosure.
AT-WILL RELATIONSHIP: I understand that nothing contained in the application, or conveyed during any interview which
may be granted or during my employment, if hired, is intended to create an employment contract between me and the
Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period
and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no
promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me
and the Company's designated representative.