APPLICATION FOR EMPLOYEMENT
Belfast DC, LLC (BDC) is an Equal Opportunity Employer and is committed to providing employment opportunities to applicants for employments and employees without regard to race, color, religion, sex, age, national origin, ethnicity, pregnancy, gender identity, sexual orientation, martial and family status, physical or mental disability, uniformed service, protected veteran status, genetic information or any other characteristic protected by law. BDC is a drug- and alcohol-free workplace.
Entity:
BDC
* Applicant's Type:
- Select type -

* Job Title:
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* Hourly Rate/Salary($):
* Date Available:
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* First Name:
Middle Name: * Last Name:
* Address:
Street/P.O. Box: * City:
* State:
-- select region --

* Zip:
* Country:
United States

* Email:
Cell Phone: Home Phone:
SSN No Gender:
- Select -

* Are you 18 years of age or older?
If no, can you provide a work permit?
If Hired, can you show your legal right to work in U.S.?
Type of work:
What Days are you available to work?
How did you learn of this opening?
Do you have any relatives employed by BVC?
If yes, give name(s)
Can you perform any essential function of the job with or without resonable accommodations?
Please list any additional information that relates to your ability to perform the job for which you have applied.
Branch of Service: From:
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To:
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Rank/Type of Service: Job Related Trainning/Experince:
High School Name: High School Address:
Area of Study/Major: Highest Grade Completed:
Diploma/GED: GPA :
Additional Skill and Trainning
Please list any additional information that relates to your ability to perform the job foe which you have appled such as licenses, certificates (e.g., welding, apprenceship or journeymen card), profesional memberships, computer experience, special tools/equipment, technical skills, etc.
Advanced Education / Training
Type Name of School Address Area of Study/Major Dates Attended Degree/Certificate GPA
College
Trade
Other
` List most recent employment first.
Present Employer: Dates of Employment: From:
- Month -
-Year-
To:
- Month -
-Year-
Address: Phone Number:
Job Title: Supervisor's Name and Title:
Brief Discription of Duties: Start Wage:
Current Wage:
Reason for Wanting to Make a Change: May We contact present employer?
Previous Employer: Dates of Employment: From:
- Month -
-Year-
To:
- Month -
-Year-
Address: Phone Number:
Job Title: Supervisor's Name and Title:
Brief Discription of Duties: Start Wage:
End Wage:
Reason for Leaving:
Previous Employer: Dates of Employment: From:
- Month -
-Year-
To:
- Month -
-Year-
Address: Phone Number:
Job Title: Supervisor's Name and Title:
Brief Discription of Duties: Start Wage:
End Wage:
Reason for Leaving:
Previous Employer: Dates of Employment: From:
- Month -
-Year-
To:
- Month -
-Year-
Address: Phone Number:
Job Title: Supervisor's Name and Title:
Brief Discription of Duties: Start Wage:
End Wage:
Reason for Leaving:
If applying for position which may require driving.
License# State Issued Classification Issue Date Expiration Date
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Do not include relatives.
Name Occupation Yrs. Known Address Telephone No.
DRUG AND ALCOHOL FREE WORKPLACE
BELFAST VALLEY CONTRACTORS, INC. (BVC) IS A DRUG AND ALCOHOL FREE WORKPLACE TO ENSURE WORKER SEAFTY AND INTEGRITY OF THE WORKPLACE, BVC PROHIBITS THE ILLEGAL MANUFACTURER, POSSESSION, DISTRIBUTION OR USE OF CONTROLLED SUBSTANCES IN THE WORKPLACE BY EMPLOYEES OR THOSE WHO ENGAGE OR SEEK TO ENGAGE IN BUSINESS WITH BVC. AN OFFICER OF EMPLOYMENT MAY BE CONTINGENT UPON PASSING A DRUG SCREENING THAT MAY INCLUDE ALCOHOL TESTING OR A PHYSICAL EXAMINATION.
*Applicant's Signature:
*Date:
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POLYGRAPH PROTECTION FOR APPLICANTS IN MARYLAND
UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMANDED, AS A CONDITION OF EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. ANY EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANORS AND SUBJECT TO FINE NOT EXCEEDING $100.
*Applicant's Signature:
*Date:
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AUTHORIZATION AND RELEASE: PLEASE READ AND SIGN
I UNDERSTAND THAT BELFAST VALLEY CONTRACTORS, INC. (BVC) FOLLOWS AN EMPLOYMENT-AT-WILL POLICY, IN THAT BVC OR I MAY TERMINATE MY EMPLOYMENT AT ANY TIME, OR FOR ANY REASON CONSISTENT WITH APPLICABLE STATE OF FEDERAL LAW. THE EMPLOYMENT-AT-WILL POLICY CANNOT BE CHANGED VERBALLY OR IN WRITING, UNLESS THE CHANGE IS SPECIALLY AUTHORIZED IN WRITING BY THE PRESIDENT OF BVC. I UNDERSTAND THAT THIS APPLICATION , COMPANY MANUALS, EMPLOYEE HANDBOOKS OR HUMAN RESOURCES GUIDELINES AND PRACTICES WILL NOT CONSTITUTE A CONTRACT OF EMPLOYMENT. I UNDERSTAND THAT FEDERAL LAW PROHIBITS THE EMPLOYMENTS OF UNAUTHORIZED ALIENS. ALL PERSONS HIRED MUST SUBMIT SUCH PROOF WILL RESULT IN DENIAL OF EMPLOYMENT. I UNDERSTAND THAT BELFAST VALLEY CONTRACTORS, INC. (BVC) WILL THOROUGHLY INVESTIGATE MY WORK AND PERSONAL HISTORY AND VERIFY ALL DATA GIVEN ON THIS APPLICATION, ON RELATED PAPERS, AND IN INTERVIEWS. I AUTHORIZE ALL INDIVIDUALS , SCHOOLS, AND ORGANIZATIONS NAMED THEREIN, EXCEPT MY CURRENT EMPLOYER IF SO NOTED, TO PROVIDE ANY INFORMATION REQUESTED ABOUT ME, AND I RELEASE THEM FROM ALL LIABILITY FOR DAMAGE IN PROVIDING THIS INFORMATION. I FURTHER UNDERSTAND THAT ANY OFFER OF OR CONTINUATION OF EMPLOYMENT MAY BE CONTINGENT UPON PASSING DRUG SCREENING THAT MAY INCLUDE ALCOHOL TESTING AND A PHYSICAL EXAMINATION , AND SATISFACTORY COMPLETION OF BONDING, MOTOR VEHICLE REPORT CLEARANCES REFERENCE CHECKS, BACKGROUND INVESTIGATIONS, CREDIT CHECKS AND OTHER INQUIRES AS NEEDED, AND I EXPRESSLY AUTHORIZE SUCH ACTS. I CERTIFY THAT ALL STATEMENTS HEREIN ARE TRUE AND UNDERSTAND THAT ANY FALSIFICATION OF INFORMATION OR WILLFUL OMISSION SHALL BE SUFFICIENT CAUSE FOR DISMISSAL OR REFUSAL OF EMPLOYMENT.
*Applicant's Signature:
*Date:
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Crew:
-- select --
Project:
-- select --
Arrange Interview: Remarks:
Interviewer: Interview Date:
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Hire:
Orientation Date:
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Remarks:
Time Keeper:
-- select --
Department: Tier:
Experience: Orientation/Handbook: Race/Ethnic Group:
- Select -
State of Residence: Incent: TL Set-Up:
CW Set-Up: Employee ID: Employee:
ID Type:
- Select ID Type -
ID Expiration:
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Notes:
Drug Screening:
- Select Result -
Drug Screening Date:
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This application will be active for a period of time not to exceed 45 days. Any aplicant wishing to be considered for a employment beyond this time period should inquiry as to whether or not applications are being accepted at that time.
3365 V NE, Washington D.C., 20018 | Phone: 202.930.4811