400 Lancaster Street
Oakland, CA 94601

Application for Employment

To help us learn about your experience, abilities, and interests, please complete
this Application for Employment as thoroughly as possible.

 

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APPLICANT INFORMATION


Last NameFirst NameMiddle InitialDate


Street Address Home Telephone


CityStateZIP Other Telephone

Have you ever applied for employment with us before? Y NIf Yes: When

Have you ever been employed by us before? Y NIf Yes: Which location

Position applying for: Location:

Date available to start: Desired salary: $

Can you, upon hire, verify your identity and submit verification of your legal right to work in the United States in compliance with federal law by completing the required employment verification document (I-9)? Y N

Have you ever been convicted of a felony? (Do not include marijuana related convictions which occurred more than two years prior to the date of this application? Y N

If yes, please explain:

If you are under 18 years of age, can you, upon hire, supply proof of age and/or a Work Permit? Y N

If hired, do you have reliable means of transportation to get to work? Y N

How were you referred to the Company?
Advertisement Employee Referral Walk-in Agency Other

Please list source:

EDUCATION

School Name & Location
of School
Course of Study No.Years
Completed
Did You
Graduate?
Degree
or Diploma
College/
University
Y N
Business/Trade
Technical/Order
Y N
High School Y N

F&S complies with The Americans With Disabilities Act and State Law. If you feel that you require reasonable accommodation, at any step of the interview/application process please notify us within a reasonable time. We may request that you support your request with medical documentation.

EMPLOYMENT RECORD

Please list in order of most recent employment first.

If currently employed may we contact your present employer about this application? Y N

Company: Phone: Personnel Only
Address: Supervisor:
From:
To:
Starting Salary: $
Ending Salary: $
Job Title:
Responsibilities:
Reason for leaving:

Company: Phone: Personnel Only
Address: Supervisor:
From:
To:
Starting Salary: $
Ending Salary: $
Job Title:
Responsibilities:
Reason for leaving:

Company: Phone: Personnel Only
Address: Supervisor:
From:
To:
Starting Salary: $
Ending Salary: $
Job Title:
Responsibilities:
Reason for leaving:

Company: Phone: Personnel Only
Address: Supervisor:
From:
To:
Starting Salary: $
Ending Salary: $
Job Title:
Responsibilities:
Reason for leaving:

MILITARY

Have you acquired, or were you trained in any skills relevant to the position applied for while in the U.S. military service? Y N If yes, please explain.

REFERENCES

Please list professional/work references who are familiar with your work experience we may contact.

Name/TitleCompany AddressTelephone

ADDITIONAL INFORMATION

Additional Education, Vocational and/or Professional Information

  • Please attach any written resume or other summary of information which is relevant to the position for which you are applying. If familiarity with specific skills or a foreign language as listed on the job description, please describe your skills below.
  • List professional memberships, certificates or licenses. (Exclude those indicating race, color, religion, sex, sexual orientation, national origin, age physical or mental disability or labor organization affiliations.)
Foreign Language
Computer Skills
Professional Membership /
Certificates / Licenses

PRE-EMPLOYMENT CERTIFICATION

Please Read Carefully, Initial Each Paragraph, and Sign Below.


Initial
I understand that this application is only valid for the position applied for and that F&S is not obligated to retain or consider this application for future openings.

Initial
I authorize my current and former employers, supervisors, and other references listed above to give F&S representatives any and all information regarding my previous employment and any pertinent information they may have regarding me. I release F&S and previous employers and supervisors from liability for any damage that may result from furnishing information to F&S. I waive all privacy interests in such information whether I agree or disagree with the content of the disclosed information.

Initial
If I am offered employment, I understand and agree that I may be required to undergo a physical examination at F&S's expense and that my offer of employment may be conditional by that examination. I agree to authorize release of all results or information obtained from such physical examinations.

Initial
If employed by F&S, I understand that my continued employment may be contingent upon successful clearance from an U.S. Customs and FBI background investigation.

Initial
If employed by F&S, I will abide by F&S's instructions, policies and rules. I understand that I will be required to possess a current valid state issued driver's license if my position requires me to drive in the course of my work and be insurable.

Initial
I agree to submit to legally permissible drug and/or alcohol testing upon request by F&S or government agency. I recognize that the results of these tests may be used to determine my employment or continued employment. I understand and expressly agree that if employed by F&S that storage areas provided for me (locker, desk, etc.) are open to inspection by F&S without prior notice to me.

Initial
If I am employed by F&S, I understand that my employment can be terminated, with or without cause and with or without notice, at any time at the option of F&S or myself. I understand that, other than the CEO of F&S no manager, supervisor or representative of F&S has authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing. Only the CEO of F&S has the authority to make any agreement contrary to the forgoing and then only in writing. I further expressly agree that, with respect to the at-will employment relationship, this constitute the full, complete and final expression of the parties' intent concerning the nature of any employment relationship between myself and F&S.

Initial
Any controversy, dispute or claim arising out of either the failure to offer employment, or the termination of my employment, including any contention that such violated any contractual right, law or statute, or was otherwise wrongful or in violation of any implied term or covenant, including the covenant of good faith and fair dealing, shall first be submitted to binding arbitration administered by JAMS pursuant to its Employment Arbitration Rules & Procedures and subject to JAMS Policy on Employment Arbitration Minimum Standards of Procedural Fairness, and judgment on the award rendered by the arbitrator may be entered in any court having jurisdiction. I further agree that in the event an arbitration is held, each party shall pay the fees of his or her own attorneys, and shall share equally the costs of the arbitration, including but not limited to, the costs of a court reporter for the hearing.

Initial
F&S is an Equal Opportunity Employer. Applicants for all job openings are welcome and will be considered without regard to race, color, religion, national origin, sex, age, sexual orientation, physical or mental disability, or any other basis protected by state, federal or local law. It is the intent of F&S to comply with all applicable federal, state and local legislation concerning equal opportunity in all facets of employment.

I certify that I have answered truthfully and have not knowingly withheld any information relative to my application. I understand that any misrepresentation of this application may result in my being eliminated from further consideration. I further understand that, if accepted for employment, any misrepresentation which becomes known to F&S may be cause for termination. I understand that nothing contained in this application, or conveyed in the interview, creates an employment contract.

Full NameEmailDate



400 Lancaster Street
Oakland, CA 94601

Voluntary Self Identification


Fairn and Swanson Inc. welcomes diversity in the workplace and is an Equal Employment Opportunity employer. We conduct all employment-related activities without regard to race, color, religion, gender identity, marital status, age, disability, veteran status, sexual orientation, national origin, or other classification protected by applicable State and Federal employment discrimination laws.

To assist F&S in maintaining accurate employment records and comply with Federal government reporting requirements, your assistance is requested. The information you provide, below, is considered entirely voluntary and confidential, and will be used only for data reporting requirements. If you choose not to self-identify, your employment status will not be affected in any way. Your form will be separated from your application and will not be considered in connection with your application.


Position Applied ForDate

Gender: Male Female
Last NameFirst NameMiddle Initial

Race/Ethnic Group: Please check one of the descriptions below corresponding to the race/ethnic group with which you identify.

American Indian or Alaskan Native (not of Hispanic Origin) - A person having origins in any of the original peoples of North America and South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian (not of Hispanic Origin) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Black or African American (not of Hispanic Origin) - A person having origins in any of the Black racial groups of Africa.
Native Hawaiian or Other Pacific Islander (not of Hispanic Origin) - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
White (not of Hispanic Origin) - A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.
Hispanic or Latino (All races) - A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
Two or more races
Do not wish to disclose. Select this option if you do not wish to participate in our survey.

Veteran Status: Please check all which describes your veteran status.

Special Disable Veteran. - A person who has a disability that entitles them to Veterans' Administration disability compensation rated at 30 percent or more; or was discharged or released from active military duty because of a disability incurred or aggravated in the line of duty.
Vietnam Era Veteran - A person who: (i) served on active duty in the U.S. military, ground, naval or air service for a period of more than 180 days, and who was discharged or released there from with other than a dishonorable discharge, if any part of such active duty was performed: (A) in the Republic of Vietnam between February 28, 1961 , and May 7, 1975; or (B) between August 5, 1964, and May 7, 1975, in all other cases; or (ii) was discharged or released from active duty in the U.S. military, ground, naval or air service for a service-connected disability if any part of such active duty was performed (A) in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or (B) between August 5, 1964, and May 7, 1975, in any other location.
Other Protected Veteran - A person who served in the military, ground, naval or air service of the United States on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized.
Newly Separated Veteran - A person who served on active duty in the U.S. military, ground, naval or air service and was discharged or released from active duty within the past 12 months.
None of the above
Do Not Wish to Disclose. Select this option if you do not wish to participate in our survey.