Application for Emplyment Application for Emplyment If you are human, leave this field blank. Thank you for applying for a position with Safe Inc. of Schenectady. It is required that all applicants complete this form. Once your employment application is reviewed, it will be processed through the New York State Justice Center. You may not be eligible for an interview unless this step has been completed. Additional paperwork will need to be processed through the State Central Register. Northeast Testing Upstate will process your drug test. You will then need to be fingerprinted and have a criminal history background check. This procedure is a mandatory prerequisite to employment at Safe Inc. of Schenectady Personal Information Name * First MIddle Middle Last * Last Current Address * Current Address Current Address Current Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Email * Phone * Position(s) of interest * Employment Type * Full time Part time Specify days/hours available * Previously employed Were you previously employed at safe Inc? When * Do you have any skills or qualifications which you believe would benefit your employment at Safe Inc. of Schenectady Date available to begin employment at Safe Inc. of Schenectady * It is illegal for an employer to discriminate against an employee or potential employee on the basis of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age (40 or older), disability or genetic information. Education Type of school * High School College Other Type of school Name of School * School Address * Course of Study * Highest Level Completed * Add Remove Do you have any specialized training, apprenticeship skills or licensures? If so, please list Employment Please give accurate, complete, full-time and part-time employment record. Start with present or most recent employer. Company Name Phone Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Job Title/Experience Add Remove 1. In accordance with New York State Law, an applicant’s criminal record may be reviewed. 2. Provisions of Section 424-a of the Social Services Law enacted in Chapter 480 of the Laws of 1980, require that Safe Inc. make inquiry to the New York State Child Abuse and Maltreatment Register regarding prospective employees, to see if that prospective employee has been reported or is currently the subject of an indicated child abuse or maltreatment report. It is a NYS requirement that Safe Inc. not to hire candidates listed with the Register for indicated cases or while a case is in active investigation. Answer all questions Are you over 18 years of age? * Yes No If not 18, employment is subject to verification of minimum legal age. Have you ever been bonded? * Yes No If yes, with which employer? * State the names of relatives or friends currently employed by Safe Inc. Employment Agreement I understand that my employment is dependent upon satisfactory completion of all background checks, physical examination, and agreement to employment. I also consent to any and all job related medical examinations required by the organization and understand that if I am employed I will be on an orientation period from date of employment and I agree to abide by the policies, procedures, and rules of the personnel policies handbook and/or other agreements, policies and procedures which may be in effect. Upon my termination, I authorize the release of reference information of my work. I hereby certify that my answers in this application are true and correct. I grant permission for safe inc. to investigate and verify any and all information provided by me and release safe inc. and all persons who respond to its inquires from any and all liability resulting from such investigation. I understand that I may be discharged or refused employment if any statement in this application is false. Signature * Date * reCAPTCHA Submit
