Equal Employment Opportunity Statement: Employment decisions will be based on the principles of equal opportunity. All personnel actions (recruiting, hiring, training, promotion, compensation, etc.) are administered without regard to any characteristic protected by federal, state, or local law, provided the applicant/associate is able to perform the essential job functions. Reasonable accommodations will be made for disabilities and religious beliefs. Please inform us of any necessary accommodations to the application process. PERSONAL DATA Position(s) Applied for: Print Full City: State: Zip Code: Email Application for Employment Alternate Phone Number: Date of Application: Are you legally authorized to work in the United States? Yes No Will you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)? Yes No If you are under the age of 18, can you provide a valid work permit if hired? Yes No N/A Are you willing to work overtime? Yes No Compensation Desired: Can you perform the essential functions of the job with or without reasonable accommodation? Yes No Need more information on essential functions of the job If no, please describe job functions you are not able to perform: EDUCATIONAL EXPERIENCE High School: College: Form Date 7/1/15 CDH Partners Employment Application Page 1
College: Trade, Business, or Correspondence School: _ Have you ever worked or attended school under another name? Yes No If yes, please list the name you used and when you used this name. Describe any specialized training, apprenticeships, licenses and skills that you have acquired. MILITARY Have you ever served in the Armed Forces of the United States? Highest rank or rate attained: If yes, which branch: Please describe any work experience or skills gained in the military services that relates to the position you are applying for: WORK EXPERIENCE Please list your complete business and military employment starting with your most recent position. This information is required in addition to your resume. Employer Form Date 7/1/15 CDH Partners Employment Application Page 2
Employer Employer Employer Form Date 7/1/15 CDH Partners Employment Application Page 3
OTHER INFORMATION Do you have any friends or relatives currently working for CDH Partners? Yes No If yes, please state name and relation to associate: Do you have a valid driver s license (driving positions only): Yes No N/A Please list any additional languages that you are proficient in: Are you willing to relocate? Yes No PROFESSIONAL EMPLOYMENT REFERENCES Organization & Organization & Organization & Organization & How long have you know this person? APPLICANT S STATEMENT PLEASE READ CAREFULLY BEFORE SIGNING: Form Date 7/1/15 CDH Partners Employment Application Page 4
I understand that completion of this application does not in any way obligate CDH Partners to hire me or offer me a job. Should I receive an offer of employment, I understand that to be employed I must produce documents, specified by the federal government, establishing my identity and authorization for employment in the United States. I understand that, as a matter of Company policy, my employment shall continue only as long as mutually agreeable, and may be terminated by the Company or me without cause or notice. No manual, policy, or statement by any Company representative (other than a formal agreement signed by the President or Vice President, Human Resources) may be considered a contract of employment, whether express or implied, for any specific period of time or upon any continuing term. 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 to the foregoing questions and statements are true and correct. 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. I hereby authorize CDH Partners to investigate my background and performance, and to verify all information in this application. I also authorize all former employers, educational institutions, references, and others with knowledge about me to provide any information they may have regarding me to the Company. I hereby release all former employers, educational institutions, references, and others with knowledge about me from any liability/damages for providing this information. I also release CDH Partners from any liability/damages for collecting information about me and using it to make employment decisions. If hired, I agree to conform to the Company s policies and rules as issued or amended from time to time. I understand this application will remain active for the next 180 days, and if I have not been hired by that date, I must apply again to be considered for employment. Signature of Applicant: Date: Print Form Date 7/1/15 CDH Partners Employment Application Page 5