Application for Employment

Position Being Applied For

Past Employment

Education

Physical Record

Equal Employment Opportunity
(EEO) Self-Identification Form (Completion of this form is Voluntary)

Cleer Vision Windows, INC is an equal employment opportunity/affirmative action
employer. It does not discriminate on the basis of race, color, national origin,
sex, religion, ancestry, age, sexual orientation, marital status, disability,
veteran status, citizenship status, or any other protected characteristic.
Certain laws and regulations regarding equal employment opportunity, and/or
affirmative action require us to compile, maintain, and report certain
information on employees. In order to comply with these laws and regulations, we
are requesting your cooperation in completing this voluntary EEO
Self-Identification form. The information on this EEO Self-Identification form
is being requested and will be used solely for record keeping and reporting
purposes. Submission of this form by you is voluntary. Please be assured that
you will not be subjected to any adverse treatment if you do not provide the
information requested. In the even that you do provide the information
requested, the information and this form will be processed and maintained
separately from your employment application forms and your personnel file. For
the purpose of this form, please indicate the group in which you appear to
belong, identify with, or regarded in the community as belonging to. However,
only count yourself in one ethnic/minority group.

Disclaimer – By signing, I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being hired or lead to my dismissal if hired. I also provide consent for former employers to be contacted regarding work records. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I understand and agree that, if hired, my employment is for no definite period , and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.

Position Being Applied For

Past Employment

Education

Physical Record

Aviso de responsabilidad: al firmar, certifico que la información anterior, según mi leal saber y entender, es correcta. Entiendo que la falsificación de esta información puede evitar que me contraten o dar lugar a mi despido en caso de ser contratado. También doy mi consentimiento para que se contacte a empleadores anteriores con respecto a los registros laborales. Autorizo la investigación de todas las declaraciones contenidas en este documento y las referencias enumeradas anteriormente para brindarle toda la información relacionada con mi empleo anterior y cualquier información pertinente que puedan tener, personal o de otro tipo, y libero a todas las partes de toda responsabilidad por cualquier daño que pueda resultar de proporcionándote lo mismo. Entiendo y acepto que, si me contratan, mi empleo no es por un período definido y puede, independientemente de la fecha de pago de mi sueldo y salario, ser rescindido en cualquier momento sin previo aviso.