Invitation to Self-Identify
This company is subject to Executive Order 11246, as amended, which requires Federal contractors to ensure that applicants are employed and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. We are therefore requesting information about race and gender in order to comply with government reporting requirements and in order to ensure equal employment opportunity.
Submission of this information is voluntary and will be kept confidential. Refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with Federal affirmative action regulations.
*Name :
Date :
Position :
*Gender :
*Race/Ethnicity :
WHITE (not Hispanic or Latino)
BLACK or AFRICAN AMERICAN (not Hispanic or Latino)
HISPANIC OR LATINO
ASIAN (not Hispanic or Latino)
AMERICAN INDIAN/ALASKA NATIVE (not Hispanic or Latino)
NATIVE HAWAIIAN or PACIFIC ISLANDER (not Hispanic or Latino)
TWO or MORE RACES (not Hispanic or Latino)
I CHOOSE NOT TO SELF-IDENTIFY
This company is also 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 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment veterans in the following classifications:
- 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.
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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.
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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.
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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.
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.
*Veteran's section :
I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE
I AM NOT A PROTECTED VETERAN
I DO NOT WISH TO DISCLOSE MY STATUS
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AUTHORIZATION; Please read and then scroll down to submit application.
I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by Franklin Bank.
I authorize Franklin Bank to thoroughly investigate all statements contained in my application or resume. Furthermore, I authorize my former employers and references to disclose information regarding my former employment, character, and general reputation to Franklin Bank, without giving me prior notice of such disclosure. In addition, I release Franklin Bank, any former employers, and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.
I understand and agree that nothing contained in this application, or conveyed during my interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or Franklin Bank. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Franklin Bank.
I understand that my employment or continued employment, to the extent permitted by law, may be contingent upon satisfactory medical examinations and drug test, and if I am hired a condition of my employment will be that I abide by Franklin Bank's Drug and Alcohol Policy.
I understand that filling out this form does not indicate there is a position open and does not obligate Franklin Bank to hire. If hired, I agree to abide by all company work rules, policies and procedures. Franklin Bank retains the right to revise its policies or procedures, in whole or in part, at any time.