Safety & Training
Ready Mix Concrete
Porous Concrete Paving
Fire and Safety
Fairfield Inn & Suites by Marriott
Conewago Enterprises, Inc.
Liberty Property Trust
Schindler Elevator Corporation
Snyder’s Research & Development Center
Hub One Logistics
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Step 1 of 11 - Step One - Introduction
Step One – Introduction
Position(s) Applied for:
Did you live at this address for three years or more?
Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Congo, Democratic Republic of the
Congo, Republic of the
French Southern Territories
Heard and McDonald Islands
Isle of Man
Lao People's Democratic Republic
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Svalbard and Jan Mayen Islands
Trinidad and Tobago
Turks and Caicos Islands
United Arab Emirates
US Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Did you live at this previous address for three years or more?
List other name(s) under which you attended school or were employed.
Step Two – More Information About You
How did you learn about us?
Newspaper - Merchandiser
Newspaper - Evening Sun
Newspaper - York Daily Record
Newspaper - Gettysburg Times
Website - Indeed
Website - Monster
Website - CareerBuilder
Website - Conewago Enterprises, Inc.
You chose other, tell us:
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Proof of citizenship or immigration status will be required upon employment. (An I-9 form must be completed.)
Have you ever filed an application with us before?
If Yes, give date:
Are you currently employed?
May we contact your present employer?
Are you currently on lay-off status and subject to recall?
Have you ever been convicted of, or pled guilty or no contest to a misdemeanor or a felony such as fraud, embezzlement or misappropriation of funds, or false use of financial instruments, or of any other crime involving honesty?
(An affirmative answer will not necessarily preclude employment.)
If yes, give date, place, charge and disposition:
A criminal background check may be conducted by the Pennsylvania State Police as required by Act 34. Employees may be required to complete Pennsylvania Child Abuse History Clearance forms as required by Act 151.
Step Three – Limitations/Availability
Do you have any limitations regarding hours that you can work?
If Yes, explain:
Do you have any travel restrictions?
If Yes, list and explain them:
Do you have transportation?
Do you have any friends or relatives employed by this company?
If Yes, list name:
When are you available for work?
Step Four – Certifications
First Aid Certification?
Enter First Aid Certification: Expiration Date / Certifying Agency:
Enter CPR Certification: Expiration Date / Certifying Agency:
OSHA 10 Hour Construction Safety Certification?
Step Five – Military Service
Branch of Service
Length of Service
Rank/Rate at Discharge
Are you a member of the Armed Services Reserve?
Step Six – Accommodations and Transportation
Are you fully able, with or without reasonable accommodation, to perform the essential functions of the job for which you applied?
Describe how you would perform the job with or without a reasonable accommodation:
Do you have a current Drivers License?
Drivers License State
Drivers License #
Enter your Drivers License Number.
List all moving motor violations (other than parking) for the last 3 years:
Step Seven – Education
Enter below each level of education that you have achieved. Those may include: High School or GED, College, Trade School/Other, and Military.
List out the schools you have attended:
Type of School
Name of School
Address of School
Course of Study
Degree / Diploma
type of school
you have completed: High School or GED, College, Trade School, Other, and / or Military
Step Eight – Employment Experience
Enter below each previous employer.
Supervisor Name & Title
Reason for Leaving
Job Duties (Briefly)
List Professional, Civic, or Trade
Organization memberships, and any offices held:
Step Nine – Voluntary Self‐Identification of Disability
Please check one of the boxes below:
Yes, I have a disability
No, I don't have a disability
I don't wish to answer
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job:
Step Ten ‐ Appendix B to Part 60‐300 ‐ Pre‐Offer Invitation to Self‐Identify Veteran Status
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 am not a protected Veteran
I identify as one or more of the classifications of protected Veterans listed at the link below.
[ Learn more about VEVRAA ]
Step 11 ‐ EEO‐1 Self‐Identification Data Record
Are you Hispanic or Latino?
What race(s) do you consider yourself to be:
Native American/Native Alaskan
Native Hawaiian or other Pacific Islander
Two or more races
What race(s) do you consider yourself to be:
Black / African-American
Native American / Native Alaskan
Native Hawaiian or other Pacific Islander
Two or more Races
Important Authorization and Understanding
Please read this statement, and acknowledge that you have read it.
Completeness and accuracy of information. I represent that all of the information now or hereafter given by me in support of my application for employment is true and complete. I understand, that if I am hired, any false or misleading information in support of my application may subject me to discharge at any time during the period of my employment.
Authorization for release of information and release from liability. I authorize you to verify any of the information given during the application process with appropriate individuals, companies, institutions, or agencies and I authorize them to release such information as you require, including my prior disciplinary employment record, without any obligation to give me written notice of disclosure. I hereby release you and them from any liability whatsoever as a result of such inquiries and disclosures. A photocopy or other electronic reproduction of this authorization/release is binding, and may be relied upon.
Employment at will. I understand that if I am employed, I will be an employee at will. This means that either the employer or the employee may terminate the employment relationship with or without cause at any time.
No written, oral, or implied contracts. I understand that any written Company documents, oral statements, or formal or informal policies are not to be construed as granting an express or implied employment contract and that I am not entitled to rely upon any such documents, statements or Company policies as stating employment terms. The employment relationship with the Company may be modified only in writing directed to me by the President of the Company.
Benefits may be altered. I understand that the Company at its option may change, delete, suspend, or discontinue any part or parts of its benefit program at any time without prior notice, both while persons are actively employed and while retired or otherwise separated from employment with the Company.
I understand that a test for drug and alcohol misuse may be required as part of the interview process, and I hereby authorize the release of test results to the Company. I hereby consent to the performance of such medical examination and testing. I waive all claims arising out of these procedures against the Company and those performing the examination and tests. I understand and consent that as a condition of continued employment, I will submit to drug and alcohol testing in the future. I authorize the release of any such subsequent testing to the Company and waive all claims against it or those performing the examination and tests. I understand that I will be subject to immediate termination for failing to submit to examination or testing.
If an employment relationship is established, I agree to wear or use all protective clothing or devices as may be required by the Company and to comply with all safety policies and procedures.
Yes, I acknowledge that I have read and understand the above statement in its entirety, and have had the opportunity to ask questions regarding any aspect .
Accepted file types: pdf.
If you have a resume, please upload the file in PDF format.