Application for Employment

Job Title

Junior Engineer

Location

Paducah, Kentucky

It is the policy of Florence & Hutcheson, Inc. to ensure that qualified applicants are employed, and that employees are treated during employment without regard to their race, religion, color, sex, age, national origin, marital status, disability, special disabled veteran, Vietnam era veteran, or other eligible veteran status. Florence & Hutcheson complies with Title VII of the Civil Rights Act of 1964; 49 CFR, Part 26; related statutes and regulations to the end that no person shall be excluded from participation in or be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance from the U. S. Department of Transportation. Any person believing he or she has been discriminated against should contact Florence & Hutcheson, Inc. – EEO Officer – 501 Huger Street, Columbia, SC 29201.Telephone 803-258-5400.

General Applicant Info

Please enter your name as it appears on your Social Security Card:

Mailing Address & Contact Information


Are you 18 years of age or older?YESNO

Current/Former Employers (Include Military Service)

May we contact this employer?YESNO

Current/Former Employers (Include Military Service)

Current/Former Employers (Include Military Service)

Education

High School

College/Trade School

College/Trade School

College/Trade School

References (Please provide three references.)

Reference One


Reference Two


Reference Three

Affirmative Action Information

This information will not become a part of your application. Inclusion or exclusion of any of the data will not affect any employment decision. You are not required to complete this form. Your application will be considered in the same manner whether this form is completed.

It is the policy of Florence & Hutcheson, Inc. (F&H) to provide equal employment to all qualified applicants and employees regardless of race, religion, color, sex, age, national origin, marital status, disability, special disabled veteran, Vietnam era veteran, or other eligible veteran status. As a government contractor, we support affirmative action programs. In compliance with government regulations, we are required to record the number of applications received by age and sex and to report these totals to the appropriate government agencies. This information will be used only in accordance with the state and federal regulations. Your completion of the information below is voluntary.

This information is requested solely to enable F&H to meet record keeping and affirmative action requirements under Executive Order 11246, as amended, Section 402 of Vietnam Era Veterans’ Readjustment Assistance Act of 1974, Section 503 of the Rehabilitation Act of 1973, as amended, and the Americans with Disabilities Act. The information will be kept in strictest confidence.


U.S. Citizen?YESNO


Special Disabled Veteran?YESNO

A person entitled to disability compensation for a disability rates at 30 percent or more, or rated 100 or 20 percent in the case of a veteran who has been determined under Section 1506 of Title 38, U. S. C. to have a serious employment handicap, or a person whose discharge or release from active duty was for disability incurred or aggravated in the line of duty.


Veteran of the Vietnam Era?YESNO

A person who (a) served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged or released there from with other than a dishonorable discharge, or (b) was discharged or released from active duty because of a service connected disability if any part of such active duty was performed between August 5, 1964 and May 7, 1975.


Other Eligible Veteran?YESNO

Veterans who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized.


Disabled Individual?YESNO

A person who has a physical or mental impairment, which substantially limits one or more major life activities, has a record of such impairment, or is regarded as having such impairment.


Affirmative Action Definitions:

Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

White (Not Hispanic or Latino) – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino) – A person having origins in any of the black racial groups of Africa.

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.

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.

American Indian or Alaska 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.

Two or More Races (Not Hispanic or Latino) – All persons who identify with more than one of the above five races.


Terms

I certify that the answers given by me to the following questions and statements are true, correct and without omissions. In considering my application for employment, Florence & Hutcheson may verify the information set forth on this application and obtain additional background information relating to the position for which I am applying. I authorize all persons, schools, companies, corporations, credit bureaus and law enforcement agencies to supply any information concerning my qualifications for employment. I release Florence & Hutcheson and my former employers from any liability for damages which may result from such investigation. If, upon investigation, anything contained in this application is found to be untrue, I understand that any false statement(s) of material facts or omissions may subject me to disqualification or dismissal. Florence & Hutcheson Inc is an “at-will” employer. This means the individual or Florence & Hutcheson are free to end the employment relationship at any time, with or without notice, with or without cause and that employment is for no specified period. I further understand that no one other than the company’s principals has the authority to enter into an employment contract or agreement with me, and that my at-will employment can be changed only by a written agreement signed by the principal.

I understand any information divulged will be considered confidential to Florence & Hutcheson, Inc. and the organizations involved. Should you be hired, Florence & Hutcheson, Inc. participates in the E-Verify program, jointly administered by the DHS through USCIS and SSA, verifying authorization to work in the US by checking the information provided on my I-9 form against both DHS and SSA databases.

In addition, I understand that this application is good only for sixty (60) days from today’s date. If I still desire a position with Florence & Hutcheson, Inc., it will be my responsibility to fill out a new application and file it with the company.

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