Government contractors are subject to 38 USC 2012 of the veteran era veterans readjustment act of 1974 which
requires that they take affirmative action to employ and advance employment qualified disabled veterans and
veterans of Vietnam era, and section 503 of the rehabilitation Act of 1973 as amended which requires government
contractors to take affirmative action to employ and advance in employment qualified handicapped
If you are a disable veteran, or have a physical handicap, you are invited to volunteer this information. The
purpose is to provide information regarding proper placement and appropriate accommodations to enable you to
perform the job to the best of your ability in a proper and safe manner. This information will be treated as
confidential. Failure to provide this information will not jeopardize or adversely affect your consideration for
Start with your present or last job. Include military service assignments and volunteer activities.
Exclude organization names which indicate race, color, religion, sex or national origin.
By checking this box you certify that the answers given are true and complete to the best
of my knowledge.
By checking this box you authorize investigation of all statements contained in this
application for employment as
may be necessary in arriving at an employment decision. I understand that this application is not and is not
intended to be a contract of employment.
By checking this box, in the event of employment, you understand that false or misleading
information given in your
application or interview(s) may result in discharge. You understand also, that you are required to abide by all
rules and regulations of the company.
To help us prevent spam, please confirm your last name*