Apply for Laborer - Site Development

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Summary
Title:Laborer - Site Development
ID:1016
Location:State College, PA
Operation:Construction
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Application Information
If HRI, INC. Employee Referral, provide Name:
If referred by a HRI, INC. employee, please provide employee's full name.
If other, please specify:
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If Radio, provide name:
If TV, provide channel:
* Former Employee:
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Hiring Manager Rating:
Application for Employment
t
PERSONAL INFORMATION
Yes   No
Yes   No
Yes   No
Yes   No
EMPLOYMENT DESIRED
Full Time   Part Time   Seasonal
Yes   No
Yes   No
EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School 1

Yes   No

School 2

Yes   No

School 3

Yes   No

School 4

Yes   No

School 5

Yes   No
EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

Employer 1

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Yes   No
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Employer 2

Yes   No

Employer 3

Yes   No

Employer 4

Yes   No

Employer 5

Yes   No
EXPERIENCE AND QUALIFICATION

Accident History

Yes   No

If yes, please list below

Accident 1

Accident 2

Accident 3

Traffic Convictions and Forfeitures (5 years)

Yes   No

If yes, please list below

Traffic Conviction or Forfeiture 1

Traffic Conviction or Forfeiture 2

Traffic Conviction or Forfeiture 3

Section 383.21 FMOSR states "No person who operates a commercial motor vehicle shall at any time have more than one driver's license". I certify that I do not have more than one motor vehicle license, the information for which is listed below.


REFERENCES

Please provide three references (not relatives).

Reference 1

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Reference 2

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Reference 3

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AUTHORIZATION

I swear/affirm that the statements and information I have provided in this Application for Employment are true, correct, and complete to the best of my knowledge.

I certify that I have answered all questions to the best of my ability and have not withheld any information that would unfavorably affect my application for employment. I acknowledge that misrepresentation or omissions may be the cause for my rejection for employment or may result in my subsequent dismissal if I am hired. I specifically, acknowledge that the employer will use my driver record abstract(s) required pursuant to Section 6-114 of the Pa Vehicle Code for the purposes identified and for no other purpose.

I hereby consent to have HRI Inc. contact anyone it deems appropriate to investigate or verify any information I have provided or to discuss my background, past performance, or suitability for employment. I expressly consent to any discussions regarding the foregoing by any person contacted. I knowingly and voluntarily waive all rights to bring any actions for defamation, invasion of privacy, or similar cause of action against anyone providing such information. This affidavit is filed in compliance with Section 607 of the Fair Credit Reporting Act.

I understand that employment at HRI Inc. is "at-will" which means that either I or HRI Inc. can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no leader, supervisor, manager, or executive of HRI Inc., other than the President, has the authority to create an employment contract other than an at will employment contract and the President may only do so in writing that is signed by both the President and the employee in question. I represent and warrant that I am not subject to any covenant or other restriction, including non-compete and/or non-solicitation agreements, that would preclude me from accepting employment at HRI Inc. and performing all duties associated with the position for which I am applying.

Personal Identifying Questions
* Social Security Number
* Date of Birth
2023 - Voluntary Self-Identification of Disability CC-305

Voluntary Self-Identification of Disability

Form CC-305
Page 1 of 1
OMB Control Number 1250-0005
Expires 04/30/2026
Name:
Employee ID:
(if applicable)
Date:

Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.
Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your "major life activities." If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:
  • Alcohol or other substance use disorder (not currently using drugs illegally)
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
  • Blind or low vision
  • Cancer (past or present)
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or serious difficulty hearing
  • Diabetes
  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
  • Epilepsy or other seizure disorder
  • Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
  • Intellectual or developmental disability
  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
  • Missing limbs or partially missing limbs
  • Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
  • Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
  • Partial or complete paralysis (any cause)
  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
  • Short stature (dwarfism)
  • Traumatic brain injury

Please check one of the boxes below:

Yes, I have a disability, or have had one in the past
No, I do not have a disability and have not had one in the past
I do not want to answer
 
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For Employer Use Only
Employers may modify this section of the form as needed for recordkeeping purposes.

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Job Title:
Date of Hire:
Fair Credit Reporting Act Notification
FAIR CREDIT REPORTING ACT DISCLOSURE

Glenn O. Hawbaker, Inc. (the "company") intends to obtain and use a consumer report and/or an investigative consumer report from an external consumer reporting agency for employment purposes. These reports may be obtained at any time after the company receives authorization from you, including any time during the period of your employment if the company hires you. These purposes may include but are not limited to:
  • considering your application for employment;
  • making a decision whether to offer you employment with the company;
  • deciding whether to continue your employment (if you are hired by the company);
  • doing periodic rescreening of current employees, and/or;
  • making any other employment decisions affecting you, including promotion, retention, and/or reassignment.;

A consumer reporting agency is a person or business that regularly assembles or evaluates consumer credit information or other information on consumers. As an applicant or an employee, you are considered a "consumer" under the Fair Credit Reporting Act.

A consumer report may include, but is not limited to, information about your character; general reputation; personal characteristics that may be used for employment purposes; mode of living, including credit history and reports; verification of social security number; previous and current residences; employment history; motor vehicle records; criminal history, including reports from any criminal justice agency in any or all federal, state, or county jurisdictions; and, any other public records. An investigative consumer report includes similar information as consumer reports, which are obtained through personal interviews with those who are acquainted with you or who may have knowledge of any relevant information about you.

You have a right to request disclosures of the nature and scope of any investigative consumer report that the company obtains about you. A summary of your rights under the Fair Credit Reporting Act (“FCRA”) is being provided to you along with this Disclosure. This information is also available at: www.consumer.ftc.gov/articles/pdf-0096-fair-credit-reporting-act.pdf


AUTHORIZATION

I acknowledge that I have received and read the Fair Credit Reporting Act Disclosure, a Summary of Consumer Rights under the Fair Credit Reporting Act, and this authorization. I hereby authorize Glenn O. Hawbaker, Inc. and any authorized agents or third party agents pursuant to the Fair Credit Reporting Act to obtain consumer reports and/or investigative consumer reports about me from a consumer reporting agency and that they may consider information in consumer reports and investigative consumer reports as part of their decision making process regarding any aspect of my application for employment and/or employment related matters, including periodic rescreening of current employees. I agree and understand that these reports may be obtained at any time after giving this authorization, including at any time during my employment if I am hired, without additional authorization, including authorization to run periodic checks of my Motor Vehicle Record. I authorize any individual or entity having personal knowledge of me to furnish Glenn O. Hawbaker, Inc, or its designated agents with any and all information regarding me in connection with this authorization and which will be used for employment related matters by Glenn O. Hawbaker, Inc. I further authorize and acknowledge that a copy of this authorization shall be accepted with the same authority as an original. I also acknowledge that I have received a copy of the Summary of Rights under the Fair Credit Reporting Act. I certify that the information provided on this form is true and correct. I understand that any information that I provide in an employment application or that I otherwise disclose during my employment may be used to obtain consumer reports and/ or investigative consumer reports.

* Signature (type name):
* Date:
Equal Opportunity Employment
We are an Equal Opportunity employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

The information provided will be used for research, reporting, statistical purposes and to monitor legal compliance. To help us comply with these government requirements, please complete the following information.

Completion of this form is voluntary and will not affect your opportunity for employment or terms or conditions of employment if hired. We appreciate your cooperation.
Gender:
Female
Male
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Race/Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment
Black or African American (Not Hispanic or Latino)
A person having origins in any of the Black racial groups of Africa
Hispanic or Latino
A person of Cuban, Mexican, Puerto Rican, Central or South American, or other Spanish culture or origin, regardless of race
Asian (Not Hispanic or Latino)
A person having origins in any of the original 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
White (Not Hispanic or Latino)
A person having origins in any of the original peoples of Europe, North Africa, or the Middle East
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
Two or More Races (Not Hispanic or Latino)
All persons who identify with more than one of the above races
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Veteran Status: (Please check all that apply)
Vietnam Era Veteran
A person who 1) Served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases; or 2) Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed; a. in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or b. between August 5, 1964, and May 7, 1975, in all other cases.
Disabled Veteran
1) 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 Secretary of Veterans Affairs; or 2) A person who was discharged or released from active duty because of a service-connected disability.
War/Campaign/Expedition Veteran
A veteran 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.
Armed Forces Service Medal Veteran
A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order No. 12985. To identify the military operations that meet this criterion, check your DD Form 214, Certificate of Release or Discharge from Active Duty.
Recently Separated Veteran
Any veteran during the three-year period beginning on date of such veteran's discharge or release from active duty in the U. S. military, ground, naval or air service.
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I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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