All applicants must complete this form in its entirety. All blanks must be completed or the application will not be processed. If any information is not applicable, please mark “N/A” in the space provided.
Applicants are considered for the position for which they have applied without regard to race, color, religion, sex, sexual orientation, gender identity/expression, genetic testing, national origin, age, disability, marital status, military status, veteran status, or any other applicable legally protected characteristic. Horst Engineering and all its related companies fully endorse equal opportunity for all.
You may skip this section if you do not have any other previous employer.
I understand that this employment application or the granting of an interview is not a contract or promise of
employment. I understand that no one at Horst Engineering has the authority to enter into an agreement for employment for any specified period of time or make any change in policy, procedure, benefit or other terms or condition of employment other than in a document signed by the President/CEO or his authorized representative.
I understand and agree that if hired, my employment will be at-will and it may be terminated, with or without cause, at any time, by me or Horst Engineering. I also understand that this written statement supersedes any and all oral representation made by agents or representatives of this Company.
I understand that, if offered for employment, I must successfully pass a background check. If offered employment, I authorize Horst Engineering and its representatives to contact my prior employers and all others for the purpose of verification of information I have supplied. If offered employment, I authorize employers, schools and other persons named on this verification to provide information pertaining to your social security number, current and previous residences, employment history, education, character references, criminal history, birth records, and motor vehicle records. I agree that Horst Engineering is not responsible for damages resulting from loss of employment if an applicant provides notice of resignation to his/her current employer and fails any portion of the post-offer assessments.
I understand where permissible under applicable state and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result before being permitted to commence work with Horst Engineering.
As a condition of any employment I may be offered, I understand I must complete an appropriate Employment Eligibility Verification form I-9, and provide proof of identification and right to work as required by law; and if I have been in the U.S. Military Service, my form DD214.
I certify under penalty of perjury, that this application was completed by me and that all entries on it, and information in it, are true and complete. I understand that false answers, statements, or omissions shall be sufficient cause for denial of employment or discharge from employment regardless of the time lapse before the discovery. I am aware that my application for employment may not be considered if there is missing information and/or signature.
By typing my name below and submitting this form, I am signing this Agreement electronically. I agree my electronic signature is the legal equivalent of my manual signature on this Agreement. I consent to be legally bound by this Agreement's terms and conditions.
Horst Engineering has a strong commitment to provide its employees with a working environment that is free of illegal drugs and alcohol. We are committed to delivering quality products and services to our customers. In so doing, we intend to protect the safety of our employees, the safety of those who use our products and services, and our national security. There is no place for substance abuse in our company.
PRE-EMPLOYMENT DRUG TESTING POLICY
NOTICE TO APPLICANT
Horst Engineering’s policy is to conduct a urinalysis drug test as part of its pre-employment procedure. You are asked to read the above information which summarizes Horst Engineering’s policy. This acknowledgment, once signed by you, will be retained with your employment application, and is necessary to complete the employment application process.
Your digital signature below acknowledges receipt of written notification of Horst Engineering’s intent to conduct a urinalysis test, as part of its pre-employment procedure.
**For applicants in Connecticut: Applicants are not required to disclose the existence of an arrest, criminal charge or conviction for which records have been “erased.” The types of records subject to erasure under Connecticut law are as follows: (a) a finding of delinquency or that a child was a member of a family with service needs; (b) a sentence as a youthful offender; (c) a criminal charge that was dismissed or “nolled”; (d) a criminal charge for which the person was found not guilty; and (e) a conviction for which the person received an absolute pardon. Any applicant whose criminal records were erased will be considered to have never been arrested and may so state under oath.
**For applicants in Massachusetts: Under Massachusetts law, an employer is prohibited from making written, pre-employment inquiries of an applicant about his or her criminal history. MASSACHUSETTS APPLICANTS SHOULD NOT RESPOND TO ANY WRITTEN QUESTIONS ABOVE ON THIS APPLICATION FORM SEEKING CRIMINAL RECORD INFORMATION. Applicantsarerequiredtodisclosecriminalrecordinformation orally during any interview. Applicants are not required to provide a copy of their Criminal Offender Record Information to The Company at any time. Applicants may further answer “no” to any questions asked in an interview or thereafter regarding convictions involving: (1) a first conviction for one of the following misdemeanors: minor traffic violation, speeding, drunkenness, simple assault, affray, or disturbance of the peace; or (2) a conviction for a misdemeanor where the date of conviction or completion of any period of incarceration is more than five years prior to the date of this application for employment. In addition, an applicant for employment with a sealed record on file with the commissioner of probation may answer “no record” with respect to an inquiry relative to prior arrests, criminal court appearances or convictions. An applicant for employment with a sealed record on file with the commissioner of probation may answer “no record” to an inquiry herein relative to prior arrests or criminal court appearances. In addition, any applicant for employment may answer “no record” with respect to any inquiry relative to prior arrests, court appearances and adjudications in all cases of delinquency or as a child in need of services, which did not result in a complaint transferred to the superior court for criminal prosecution.
**For applicants in New York: Applicants are not required to disclose the existence of an arrest or detention that did not result in conviction, a criminal proceeding terminated in a youthful offender adjudication, or convictions that are sealed.
I understand that the information provided above will not necessarily result in the rejection of my application, but that the nature of the information will be considered as it relates to the performance of the job duties in question and in light of the requirements of state and federal law.
As part of the application process, Horst Engineering and its business affiliates, subsidiaries and/or divisions (“The Company”) may conduct a background check. If you are hired, The Company may also conduct a background check in deciding whether to continue your employment and when making other employment-related decisions directly affecting you. As part of the background check, The Company may obtain a “consumer report” from a “consumer reporting agency.” These terms are defined in the Fair Credit Reporting Act (“FCRA”), which applies to you. A consumer report may include information regarding such issues as your credit standing,* criminal record,** motor vehicle record, character and reputation. If The Company obtains a “consumer report” about you, and considers any information in the “consumer report” when making an employment-related decision that directly and adversely affects you, you will be provided with a copy of the report before the decision is finalized and other information required by the FCRA (including a summary of your rights under the FCRA and the name, address and telephone number of the consumer reporting agency and other applicable federal agencies).
You are required to provide the following information so that The Company may conduct the background check:
*For individuals in Connecticut: The Company may only obtain and/or use a credit report pertaining to any Connecticut applicants/employees when: (a) the report is required by law; or (b) The Company reasonably believes the employee engaged in any activity that constitutes a violation of the law related to his/her employment; or (c) the report is substantially related to the applicant/employee’s current or potential job or when The Company has a bona fide purpose for requesting or using the information in the credit report that is substantially job-related and is disclosed in writing to the applicant/employee.
**For applicants in Massachusetts: The Company will not obtain and/or use a criminal background report pertaining to any Massachusetts applicants until they are interviewed or thereafter.
I have applied for employment with Horst Engineering and/or one or more of its business affiliates, subsidiaries and/or divisions (hereafter “The Company”). If offered employment, I understand investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. Specifically, I hereby authorize Baker Street Associates as directed by The Company to conduct a thorough background investigation for the purpose of my eligibility for employment with The Company. I understand that representatives of The Company may obtain pertinent information from my previous employers, references, and other persons with knowledge of my work history and background, financial history, education, regulatory or police records, driving records, licensing status or professional designation, and character or reputation, and to consider the information provided by the background check when making decisions regarding my employment at The Company. I authorize all previous employers, references or other persons or agencies having knowledge of my record or myself to release such information to The Company.
My digital signature below authorizes The Company to obtain consumer reports regarding me from any and all federal, state and local reporting agencies in connection with my application and, if hired, during the course of my employment. I hereby authorize, without limitation, any consumer reporting agencies or information service bureaus contacted by those reporting agencies to furnish the above-referenced information. I realize that my employment with The Company is conditional on a favorable background investigation and that any misrepresentation of the facts on my part will immediately terminate any application and my eligibility for employment.
I acknowledge that a photocopy, facsimile or electronic copy of this authorization shall be as valid as and may be accepted in lieu of the original.
Horst Engineering is subject to certain governmental record-keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, Horst Engineering invites all applicants/employees to voluntarily self identify their race and ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information will be kept confidential and will only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.
Horst Engineering also complies with government regulations including but not limited to affirmative action responsibilities as required under Executive Order 11246, Section 503 of the Rehabilitation Act of 1973, section 4212 of the Vietnam Era Veterans Readjustment Act of 1974 and Veterans Employment Opportunities Act (VEOA) of 1998.
This data is for periodic government reporting and will be kept in a Confidential File separate from the Application for Employment.
You are not required to provide this information, but your cooperation in completing this form is appreciated.
Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified veterans in accordance with the Vietnam Era Veterans Readjustment Assistance Act of 1974, as amended. To help us measure how well we are doing, we are asking you to tell us if you are a qualified veteran. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
If you already work for us, your answer will not be used against you in any way. Because a person may become a veteran 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 being a veteran on this form without fear of any punishment because you did not identify as being a veteran earlier.
How do I know if I am a Qualified Veteran?
You are considered to be a qualified veteran if you are one of the following.
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities in accordance with Section 503 of the Rehabilitation Act of 1973. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
If you already work for us, 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 fear of any punishment because you did not identify as having a disability earlier.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.
Disabilites include, but are not limited to: