Our Legacy

Applicant Data Record

Applicant and Team members are treated during employment without regard to race, color, religion, sex, national origin, marital or veteran status, medical condition, or handicap/disability, or any other legal protected status. We comply with government regulations, including affirmative responsibilities where they apply. Solely to help us comply with governmental record keeping, reporting and other legal requirements, we request that you please fill out the Applicant Data Record. We appreciate your cooperation.

This data is for periodic government reporting and will kept in a Confidential File separate from the Applicant for Employment. YOUR COOPERATION IS VOLUNTARY.

Position you're applying for:
Name
Address
City
State
Zip Code
Referral Source Advertisement
Employment Agency
Friend
Relative
Other

Confidential Information Voluntary Survey

Various government agencies request statistical information regarding our hiring practices. Your cooperation in completing this form is completely voluntary. Any information gathered is strictly confidential and will not subject you to coercion or intimidation relating to your status. Failure to provide this information will not adversely affect your application. Thank you for your cooperation

Male Female

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