Application


We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

Position(s) Applied For:
How Did You Learn About Us?


 
Last Name First Name Middle Name
Address City State Zip
Home Phone Number Cell Phone Number
 
Are you at least 18 years or age or older?
(If no, you may be required to provide authorization to work)
Have you ever filed an application with us before?

If Yes, give date
Have you ever been employed with us before?

If Yes, give date
Are you currently employed?
May we contact your present employer?
Are you eligible to work in the U.S.?
Proof of citizenship or immigration status will be required upon employment.
On what date would you be available for work?
Are you available to work:
Are you currently on “lay-off” status and subject to recall?
Can you travel if a job requires it?

Mona is an EO/AA/Vet/Disability Employer
 

Education


Name of School Course of Study # of Years Completed Certificate Earned
High School
College or University
Other (Specify)
Indicate any foreign language you can speak, read and/or write.
Fluent Good Fair
Speak
Read
Write
Describe any specialized training, apprenticeship, skills and extra-curricular activities.
 
Describe any job-related training received in the United States military.
 
List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or protected status:
 

Employment Experience


Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.

1.
Employer  Dates Employeed
From     To 
Address
Telephone Number(s)
Job Title
Supervisor
Reason For Leaving
Hourly Rate/Salary
Starting    Ending 
Work Performed

2.
Employer  Dates Employeed
From     To 
Address
Telephone Number(s)
Job Title
Supervisor
Reason For Leaving
Hourly Rate/Salary
Starting    Ending 
Work Performed

3.
Employer  Dates Employeed
From     To 
Address
Telephone Number(s)
Job Title
Supervisor
Reason For Leaving
Hourly Rate/Salary
Starting    Ending 
Work Performed

4.
Employer  Dates Employeed
From     To 
Address
Telephone Number(s)
Job Title
Supervisor
Reason For Leaving
Hourly Rate/Salary
Starting    Ending 
Work Performed

Additional Information


Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience.
State any additional information you feel may be helpful to us in considering your application.

References


Name Phone Number Address
1.
2.
3.

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB WHICH YOU ARE APPLYING.
Are you capable of performing the essential functions of the job or occupation for which you have applied?


Applicant's Statement




I certify that answers given herein are true and complete information.

Applicants will receive consideration for positions without regard to race, color, religion, age, gender, sexual orientation, marital status, individuals with disabilities, and equally to disabled veterans and veterans of the Vietnam Era.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or with out cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Type your name in the box below to acknowledge the above statement and to serve as your signature.
 


Do you have transportation to get to jobs in Maryland, Virginia, and Washington, D.C.?

Do you have restrictions on how far you will travel?

Do you have all you work tools as specified by Local 26?

Have you ever been written up for tardiness or absenteeism?

If I were to speak with your past employers, what would they say about your work?

What type of electrical license(s) do you have? Expiration date.

DC
MD
VA


Dear Applicant:
“Under Maryland Law, an Employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test or examination as a condition of employment or continued employment. Any Employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.00”
Mona may conduct background investigations to determine suitability for employment, as provided for under the Fair Credit Reporting Act of 1970. If you are denied employment as a result of a consumer report, the name, address and telephone number of the Consumer Reporting Agency will be supplied as directed in the FCRA.
I understand that I may review Mona’s Affirmative Action Plan and EEO Policy per my verbal or written request at any time.

Type your name in the box below to acknowledge the above statement and to serve as your signature.
 


Affirmative Action Invitation to Voluntarily Self-Identify


The purpose of this request is to comply with certain federal Equal Opportunity and Affirmative Action obligations, including those promoted by the Executive Order 11246, Section 503 of the Rehabilitation Act of 1973, Vietnam Era Veterans Readjustment Act of 1974 and 41 CFR 60-741.42. Your participation is voluntary. Your failure or refusal to provide this information will not subject you to any adverse treatment.

Name:
Position: Employer:


Race/Ethnicity



Select one of the following:






Veteran Status



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), requires certain 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:

  • A “Disabled veteran” is one of the following:
    • 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
    • A person who was discharged or released from active duty because of a service-connected disability.
  • A “recently separated veteran” means 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.
  • An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service 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.
  • An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.


Voluntary Self-Identification of Disability



Why are you being asked to complete this form?



Mona Electric Group, Inc. provides 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.



How do I know if I have a disability?



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)

Type your name in the box below to acknowledge the above statement and to serve as your signature.



Reasonable Accommodation Notice



Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the US Department of Labor’s Office of Federal Contract Compliance Programs (FCCP) website at www.dol.gov/ofccp.

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