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Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.
Disabilities include, but are not limited to:
This employer is a Government contractor 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: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:
(1) 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 (2) A person who was discharged or released from active duty because of a service‐oriented disability.
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.
A veteran who served on active duty in the U.S. military, ground, naval or air service on active duty 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.
Any veteran who while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operations to which an Armed Forces service medal was awarded pursuant to Executive Order 12985(61 FR 1209)
Protected veterans may have additional rights under USERRA ‐ the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor’s Veterans Employment and Training Service (VETS), toll‐free, at 1‐866‐4‐USA‐DOL.
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.
Begin with your most recent employment and continue with all past employment
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge.
I authorize all schools which I attended and all previous employers to furnish to Mt. Olive Pickle Company, Inc. my record, reason for leaving and all information they may have concerning me, and hereby release them and Mt. Olive Pickle Company, Inc. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.
I authorize my neighbors, friends or others with whom I am acquainted or who are acquainted with me to furnish Mt. Olive Pickle Company, Inc. with information used in connection with the evaluation of my qualifications as a prospective employee. I release such persons and organizations from any legal liability in making such statements.
I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.
I understand that should an employment offer be extended to me and accepted, I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, and regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.
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