Step 1 of 5
List your last four (4) employers, assignments or volunteer activities, starting with the most recent and working backwards in time, including military experience.
Explain any gaps in employment in comments section below.
Give the names of three persons not related to you, whom you have known at least three (3) years.
Although the following information is not mandatory, it is requested to aid the Big Bend Cares, Inc. in its commitment to Equal Employment Opportunity, Affirmative Action and to meet government record keeping, reporting and other legal requirements. This information is confidential and refusal to answer will not result in adverse treatment of any candidate. Your cooperation is appreciated.
As required, we comply with government regulations including Affirmative Action obligations where they apply.
In an effort to comply with requirements regarding government record keeping, reporting and other legal obligations, we ask that you complete this applicant data survey. Your cooperation is appreciated.
Please be advised that your survey is not a part of your official application for employment It is considered confidential information that will not be used in any hiring decision.
Government contractors subject to the Vietnam Era Veterans Readjustment Act of 1974 and the Rehabilitation Act of 1973 are required to take affirmative action to employ and advance in employment qualified disabled veterans and veterans of the Vietnam Era and qualified handicapped individuals.
You are invited to volunteer this information, if you qualify, to assist in proper placement and determining reasonable accommodation. This information will be considered confidential, and refusal to provide this information will not adversely affect your consideration for employment.
Not for interview purposes – To be filed separately from application.
This information is used to satisfy the Affirmative Action requirements of Section 503 of the Rehabilitation Act or necessitated by another federal law or regulation.