Call Toll Free 1-800-495-0163
Date of Application: Contact Email Address :
As an equal opportunity employer, Park Inc. does not discriminate in hiring or terms and conditions of employment because of an individual's race, creed, color, sex, age, disability, religion, or national origin.
Position Applying for: Date Available to Start:
Desired number of hours per week: Seasonal Permanent
PERSONAL INFORMATION
EMPLOYMENT HISTORY
List employment, starting with your most recent position. Account for any time during this period in which you were unemployed by stating the nature of your activities. If you have no prior employment history, include personal references to be contacted.
May we contact your present employer?
Employer
EDUCATION
MISCELLANEOUS
Is there any additional information involving a change of your name or assumed name that will permit us to check your work record? If yes, please explain.
Has a division of Park Inc. ever employed you under any conditions, including spot labor? If yes, when and where? Did you leave on good terms?
How did you hear about this opportunity?
Have you ever been convicted of a misdemeanor? If yes, please explain.
Have you ever been convicted of a felony? If yes, please explain.
Have you ever received a traffic violation? If yes, please explain.
Can you drive a manual transmission?
Do you have a Commercial Driver's License (CDL)?
Do you have reliable transportation to and from work?
PERSON TO CONTACT IN CASE OF EMERGENCY
This information is to facilitate contact in case of emergency and is not used in the selection process.
Full Name: Address : Phone Number: Relationship to you: Place of Employment: Address : Phone Number:
PLEASE READ THIS STATEMENT CAREFULLY
[In Office Only] Signature___________________________________________ Date____________________________
INVITATION TO SELF-IDENTIFY
Park Inc. is a government contractor which requires that we take affirmative action to employ and advance in employment qualified women, minorities, disabled veterans and protected veterans, as well as individuals with disabilities. Please let us know if you would like to be included in the affirmative action program by checking all the boxes below that apply to you. This information will only be used to assist us in fulfilling Equal Opportunity requirements to determine race, gender, disability, and veteran status of applicants as a group for each job position. Submission of this information is completely voluntary and refusal to provide it will not subject you to any adverse treatment. This information will not be kept in any individual’s personnel file and will not be viewed by any hiring managers. A written copy of the Affirmative Action Program is available for inspection by any employee or applicant for employment during normal business hours by calling Human Resources at 704-377-1755.
Name: Job Position (for which I am applying): Department: Gender:
RACE/ETHNICITY: Please note that for tracking purposes only one race/ethnic group can be listed. If you are of more than one group, please check the box for the group with which you most closely identify.
Hispanic or Latino – A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race
White(not Hispanic or Latino) - A person having origins in any of the original people of Europe, North Africa, or the Middle East
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 original peoples of Hawaii, Guam, Samoa, or other Pacific Islands
Asian(not Hispanic or Latino) - A person having origins in any of the 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/Alaskan Native (Tribal Affiliation)(not Hispanic or Latino) - A person having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community identification.
Two or More Races(not Hispanic or Latino) - A person identified with two or more races and NOT of Hispanic origin.
VETERANS STATUS: Are you a Veteran?
Veteran- you served in any branch of the U.S. military:
Special Disabled Vet - (A) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans' Affairs for a disability (i) rated at 30 percent or more, or (ii) rated at 10 or 20 percent in the case of a veteran who has been determined under 38 U.S.C. 3106 to have a serious employment handicap or (B) a person who was discharged or released from active duty because of a service-connected disability.
Vietnam Era Veteran - A veteran: (A) who served on active duty in the U.S. military, ground, naval or air service of the United States for a period of more than 180 days, and who was discharged or released there from with other than a dishonorable discharge, if any part of such active duty was performed: (i) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in any other location; or (B) who was discharged or released from active duty in the U.S. military, ground, naval or air service for a service-connected disability, if any part of such active duty was performed (i) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (ii) between August 5, 1964, and May 7, 1975, in any other location.
Newly Separated Veteran - Any veteran who served on active duty in the U.S. military, ground, naval or air service and was released or discharged therefrom, within the last 12 months
Other Protected Veteran - Any other veterans who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, other than special disabled veterans or veterans of the Vietnam era.
DISABILITY: Yes - A person who (A) has a physical or mental impairment which substantially limits one or more major life activities: (B) has a record of such impairment; or (C) is regarded as having such impairment.
