Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied will be taken into account.
List all previous employers, starting with your present or most recent position (last 10 years is sufficient) below.
List three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references are who are not related to you.
Thank you for your interest in employment with our Company. The following questions about your race and gender are included only because of government regulations, and you do not have to answer them. As an Equal Opportunity Employer, the Company does not use this information in its employment decisions, so whether or not you return this form has no effect on your application. Submitting this information is purely voluntary. If you choose to submit it, it will be kept confidential to the extent provided by law. Leaving this section blank is treated as deciding not to disclose the information, which is your right.
OPTIONAL - APPLICANTS MAY ATTACH A RESUME FILE IN EITHER .PDF OR .DOC
Form CC-305 OMB Control Number 1250-0005 Expires 1/31/2017
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. i 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.
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.
Disabilities include, but are not limited to: Blindness Deafness Cancer Diabetes Epilepsy Autism Cerebral Palsy HIV/AIDS Schizophrenia Muscular Dystrophy Bipolar Disorder Major Depression Multiple Sclerosis (MS) Missing Limbs or Partially Missing Limbs Post-Traumatic Stress Disorder (PTSD) Obsessive Compulsive Disorder Impairments requiring the use of a wheelchair Intellectual Disability (previously called mental retardation)