801-771-0933   (F) 801-355-0585

Application

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, sexual orientation, gender identity, military status, genetic information or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

    Job Posting # *

    Job applying for *

    Today's Date *

    Are you seeking:*

    Part-timeTemporaryFull Time

    employment?

    When could you start work? *


    Name *

     

     

    Email Address *

     

     

    Present Street Address *

     

    Phone *

    Are you 18 years of age or older? *

    If you are hired, you may be required to submit proof of age. If hired, you will be required to furnish proof of your eligibility to work in the U.S.

    YesNo

    Have you ever applied here before? *

    YesNo

    If yes, when?

    Were you ever employed here? *

    YesNo

    If yes, when?

    Have you ever been convicted of any law violation? (Include any plea of “guilty” or “no contest.” Exclude minor traffic violations.)*

    YesNo

     

    If yes, give details

    If employed, do you expect to be engaged in any additional business or employment outside of our job?*

    YesNo

     

    If yes, give details


     

    List Name & Address of Schools

    Number of Years Completed

    Diploma/Degree/Certificate

    High School or GED







    College or University







    Subjects Studied

    Vocational or Technical







    Subjects Studied


    What skills or additional training do you have that are related to the job for which you are applying? 

     

    What machines or equipment can you operate that are related to the job for which you are applying? 

     

    For Driving Jobs Only: Do you have a valid driver's license? 

    YesNo

    Class of License 

    State Licensed In

    Have you had your driver's license suspended or revoked in the last 3 years?

    YesNo

    If yes, give details

    List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability, genetic information or other protected status.)


    List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references.

    Note: A job offer may be contingent upon acceptable references from current and former employers.

    1. Employer

    Address

    Phone

    Duties

    From

    To

    Starting pay

    Leaving pay

    Supervisor

    Reason for leaving

     

    2. Employer

    Address

    Phone

    Main duties

    From

    To

    Starting pay

    Leaving pay

    Supervisor

    Reason for leaving

     

    3. Employer

    Address

    Phone

    Main duties

    From

    To

    Starting pay

    Leaving pay

    Supervisor

    Reason for leaving


    Have you worked or attended school under any other names?

    YesNo

    If yes, give names:

    If yes, whom do you sugggest we contact?

    Have you ever been fired from a job or asked to resign?

    YesNo

    If yes, please explain

    Are you presently employed?

    YesNo

    Give three references, not relatives or former employers

    Name

    Address

    Phone

    AFFIDAVIT,CONSENT AND RELEASE 

    PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING 

    I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

    I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

    I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required.

    I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the wrk for which I am applying.

    I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE

    Date: *

    Signature: *

    This application for employment will remain active fora limited time.Ask the organization's representative for details.


    Veteran Invitation to Self-Identify

    E-Corp is a Government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRRA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:

    • A “disabled veteran” is one of the following:
      -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
      a person who was discharged or released from active duty because of a service connected disability.

    • A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.

    • An “active duty wartime or campaign badge veteran” means 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 under the laws administered by the Department of Defense.

    • An “Armed forces service medal veteran” means 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 12985.

    Protected veterans may have additional rights under USERRA – the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll-free, at 1-866-4-USA-DOL.


    VETERAN INVITATION TO SELF-IDENTIFY

    NAME *

     

     

     DATE *

    JOB TITLE APPLIED FOR (List only one) *

    SIGNATURE *


    IF YOU BELIEVE YOU BELONG TO ANY OF THE CATEGORIES OF PROTECTED VETERANS LISTED ABOVE, PLEASE INDICATE BY CHECKING THE APPROPRIATE BOX BELOW.

    AS A GOVERNMENT CONTRACTOR SUBJECT TO VEVRAA, WE REQUEST THIS INFORMATION IN ORDER TO MEASURE THE EFFECTIVENESS OF THE OUTREACH AND POSITIVE RECRUITMENT EFFORTS WE UNDERTAKE PURSUANT TO VEVRAA.

    I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERANS LISTED ABOVEI AM NOT A PROTECTED VETERAN


    APPLICANT AFFIRMATIVE ACTION INFORMATION

    It is the policy of this organization to provide equal employment opportunity to all qualified applicants for employment without regard to age 40 and over, color, disability, gender identity, genetic information, military or veteran status, national origin, race, religion, sex, sexual orientation or any other applicable status protected by state or local law. As an affirmative action employer under E.O. 11246, we invite all applicants to identify themselves as indicated below.

    COMPLETION OF THIS FORM IS VOLUNTARY AND IN NO WAY AFFECTS THE DECISION REGARDING YOUR APPLICATION FOR EMPLOYMENT. THIS FORM IS CONFIDENTIAL AND WILL BE MAINTAINED SEPARATELY FROM YOUR APPLICATION FORM.

    NAME*

     

     

     DATE*

    Position applied for (List only one) *

    Where did you hear about this job? *

    Race/Ethnicity (You may mark one or more of the following): *

    WhiteAmerican Indian or Alaska NativeHispanic or LatinoBlack or African AmericanAsianNative Hawaiian or Other Pacific Islander

    Sex:*MaleFemaleI elect not to identify

     

    SIGNATURE*


    Voluntary Self-Identification of Disability

    Why are you being asked to complete this form?

    We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunities 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 I know if I 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, TSD

    • 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 pastI do not want to answer

    PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

    Your Name

    Today's Date



    Please attach your resume here. ( PDF or Word Document)

    Online Application form cannot be displayed on mobile and tablet screen sizes. Please use bigger screen size monitors like on Desktops or Mac Computers.

    You may also download an application form then scan and upload the completed application form and your resume below.


      Please upload your resume here. ( PDF or Word Document)


      Please upload your application form here.

      Or download an Application Form and mail or fax it, along with your resume to:

      E-Corp
      Attn: Human Resources
      PO Box 792
      Sandy, UT 84091

      Fax: 801-576-8925