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  • Laurel Technology Center14900 Sweitzer Lane - Suite 204Laurel, Maryland 20707
  • EMPLOYMENT APPLICATION
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  • Equal Opportunity Employer: Evergreen Information Technology Services, Inc. selects employees on the basis of qualifications without regard to race, religion, color, national origin, sex, marital status, age, or handicap.
  • PERSONAL
  • Instructions for Answering the Next Two Questions 1. All applicants: Do not include convictions that were sealed, eradicated, erased, annulled by a court, or expunged, or convictions that resulted in referral to a diversion program.2. Arizona, Colorado, District of Columbia, Illinois, Kansas, Minnesota, Missouri, Montana, Nevada, Rhode Island, South Carolina, and Utah applicants: Do not respond to the second question regarding arrests.3. California applicants: Do not include misdemeanor marijuana-related convictions that are more than two (2) years old or misdemeanor convictions for which probation was successfully completed or otherwise discharged and the case was judicially dismissed.4. Connecticut applicants: You are not required to disclose the existence of any arrest, criminal charge, or conviction, the records of which have been erased. Criminal records subject to erasure are records pertaining to a finding of delinquency or the fact that a child was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge that has been dismissed or nulled (not prosecuted) a criminal charge for which the person was found not guilty, or a conviction for which the offender received an absolute pardon. Any person whose criminal records have been erased is deemed to have never been arrested within the meaning of the law as it applies to the particular proceedings that have been erased, and may so swear under oath.5.District of Columbia and Washington applicants: Limit any response to the past ten (10) years.6. Hawaii and Massachusetts applicants: Do not answer the following two questions.7. Indiana applicants: Regarding arrests, limit your response to pending charges for felonies and class A misdemeanors that are less than one (1) year old.8. Michigan applicants: Regarding arrests, limit your response to felony arrests awaiting conviction or dismissal.9. New York applicants: All pending arrests or criminal accusations must be disclosed. You are not required to disclose arrests or criminalaccusations that resulted in criminal actions or proceedings which were terminated in your favor. Do not disclose criminal actions orproceedings that were sealed or classified as youthful offender adjudications. An ex-offender who is denied employment may, upon writtenrequest, receive a statement of the reason(s) for denial within thirty (30) days of the applicant"s request for such information.10. North Dakota and Oregon applicants: Regarding arrests, limit your response to pending charges that are less than one (1) year old.11. Utah applicants: Limit any response to felony convictions only. Do not respond to the second question regarding arrests.
  • Criminal Offenses Only: If you answered Yes, to either of the above two questions, please the date(s) and explain in accordance with the above instructions so that individual circumstances can be considered.
  • Criminal convictions or arrests will not automatically disqualify an applicant from a particular job. The Company will consider the nature of the crime, its seriousness, the substantial relation to the position"s functions and qualifications, the number of occurrences, the applicant"s age at the time of the crime, the time elapsed since the crime, the applicant"s work and educational history, employment references and recommendations, and the business necessity of any exclusion when required by law.
  • If Yes, please provide the date(s) and explain so that individual circumstances can be considered. (A "Yes" answer will not necessarily disqualify you from employment.)
  • EDUCATION
  • If applicable, list below any names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc.
  • List all special technical skills that you feel qualify you for the job for which you are applying (For example ... computer programming/language, software, equipment operation, special tools or machines, etc.)
  • EMPLOYMENT HISTORY
  • (Please provide a complete history of your three most recent positions. List all positions held including military, part-time, summer and volunteer. List in chronological order starting with the present or most recent position.)
  • Dates of Most Recent Employment (Month/Year)
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  • Dates of Most Recent Employment (Month/Year)
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  • Dates of Most Recent Employment (Month/Year)
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  • If you answered Yes to any of the above three (3) questions, please explain the circumstances of each occasion.
  • REFERENCES
  • Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related references.
  • APPLICANT CERTIFICATION
  • I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver"s license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside. I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company"s policy and federal, state and local law, may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company"s policies and applicable federal, state, and local law. If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right , without prior warning or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property. I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement, as well as an agreement to arbitrate. I certify that all the information on this application, my résumé, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal. This Company is an at-will employer as allowed by applicable state law, this means that regardless of any provision in this application, if hired, the Company or I may terminate the employment relationship at any time, for any reason, with or without cause or notice. Nothing in this application or in any document or statement, written or oral, shall limit the right to terminate employment at-will. No officer, employee or representative of the Company is authorized to enter into an agreement--express or implied--with me or any applicant for employment for a specified period of time unless such an agreement is in a written contract signed by the President of the Company. If hired, I agree to conform to the rules and regulations of the Company, and I understand that the Company has complete discretion to modify such rules and regulations at any time, except that it will not modify its policy of employment at-will. I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking and to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation. I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States. This application will be considered active for a maximum of sixty (60) days. If you wish to be considered for employment after that time, you must reapply.
  • I certify that all of the information that I have provided on this application is true, accurate, and complete.(By typing your name below, you agree that this is valid as your signature.)
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  • Under Maryland law, an employer may not require or demand, as a condition of employment, prospective employment, or continued employment, that an individual submit to or take a lie detector, polygraph, or similar test. An employer who violates this law is guilty of a misdemeanor and subject to a fine not to exceed $100. I have read and understand the above statement.
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  • Under Massachusetts law, it is unlawful for an employer to require or to administer a lie detector, polygraph or similar test as a condition of employment or continued employment. Federal and/or state law may prohibit the use of lie detector, polygraph or similar test as well. This application may not be applicable for all industries.
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  • *** Applicants Invitation To Self Identify *** EVERGREEN INFORMATION TECHNOLOGY SERVICES, INC. is an entity subject to Executive Order 11246; section 503 of the Rehabilitation Act of 1973, as amended; the Vietnam Era Veterans Readjustment Assistance Act (VEVRA) of 1974, as amended; the Jobs for Veterans Act (JFVA) of 2003, and/or Title VII of the Civil Rights Act of 1964 and is required to comply with certain government record-keeping requirements. Government agencies require periodic reports on the sex, race/ethnicity, disability and veteran status of applicants and employees. This data is for analysis and affirmative action only. Submission of any of the requested information is voluntary.
  • General Information
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  • Race/Ethnic Classification
  • Vets-100A
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