Fillable Printable APPLICATION FOR EMPLOYMENT of Emera Maine

APPLICATION FOR EMPLOYMENT of Emera Maine

Emera Maine

P.O.

Box 932

Bangor, ME 04402-0932

Website:

Email:

Fax: (207) 973-2813

APPLICATION FOR EMPLOYMENT

Emera Maine is an Equal Opportunity Employer. Applicants are

considered for all positions and all employees are treated during

employment without regard to race, color, religion, sex, sexual

orientation, age, disability, Vietnam Era and/or disabled veteran

status, national origin or any other characteristic protected under

federal, state or local law, and to affirmatively seek to advance the

principles of equal employment opportunity.

Name:

Last First Middle

Date:

Address:

Home Telephone: ( ) Hours you may be reached:

Work Telephone: ( ) May we contact you at work? Yes No

Position Applying For: Full-time Part-time

Have you ever worked at Emera Maine?

Department Date

Have you ever applied to Emera Maine?

Last Position Date

Are you 18 years of age or older (required for compliance with child labor laws)? If no, can you furnish a work permit, if

required? Are you currently authorized to work and remain in the United States? (Appropriate documentation will

be required upon offer and acceptance of employment.) Based on the job description, are you able to perform the essential functions

of this job with or without a reasonable accommodation?

Do you have relatives employed at Emera Maine?

Name Department Relationship

Do you have a current Maine Driver’s License? Yes No

If yes, what type? Class A Class B Class C Endorsements?

List all current and previous jobs and activities including part-time employment while in school, self-employment, volunteer work

and periods of unemployment. Exclude organization names which indicate race, color, religion, sex, sexual orientation, age,

disability, Vietnam Era and/or disabled veteran status, national origin or any other characteristic protected under federal, state or local

law. Begin with your present or most recent position.

Employer Telephone Dates Worked

Address Street City State Position Title

May we contact your current employer? Name and Title of Supervisor

Reason for Leaving:

Employer Telephone Dates Worked

Address Street City State Position Title

Name and Title of Supervisor

Reason for Leaving:

Employer Telephone Dates Worked

Address Street City State Position Title

Name and Title of Supervisor

Reason for Leaving: ---

EMERA MAINE APPLICATION FOR EMPLOYMENT

Name & Location Degree Major GPA

High School:

College:

Commercial/Trade School:

Graduate School:

Other:

Scholastic Honors:

List Publications, thesis, professional licenses:

Have you ever been convicted (including convictions now on appeal) by any law enforcement authorities for any violation of any

law, regulation, or ordinance in the last seven (7) years? For the purposes of this question, minor traffic offenses, infractions or

citations, expunged or annulled convictions (including juvenile convictions) should not be included when responding to this

question. A conviction will not necessarily disqualify you from employment. Emera Maine will consider additional factors,

including, but not limited to, the relationship between the conviction and the position held.

Offense Date City/State Final Action

Please provide three (3) business references:

Name Address Telephone Business/Profession

Earliest day you can begin employment at Emera Maine:

__________

APPLICANT: PLEASE READ CAREFULLY BEFORE SIGNING:

This application will be given every consideration, but its receipt does not imply that the applicant will be employed.

I understand that my employment and continued employment is contingent upon satisfactory consumer reports and

criminal background checks. I authorize Emera Maine to investigate, verify and discuss all information set forth in my

employment application, by contacting my prior employers, colleagues, educational institutions, and other references

set forth above, and by any and all other means authorized or permitted by law, including any consumer reports and

criminal background checks. I authorize any entity or person named in this application to provide Emera Maine with

any and all information in their possession, custody or control regarding me, whether or not it is in their records, and to

provide Emera Maine with information that may be requested by Emera Maine to arrive at an employment decision. I

hereby release and agree to hold harmless Emera Maine and its affiliates, and all of its respective employees, agents

and representatives, from any and all claims, liability or damages that may arise as a result of taking any actions

described herein. In addition, I hereby release and agree to hold harmless any and all individuals and entities that

provide any information concerning me, whether orally or in writing, in response to a request for such information from

Emera Maine.

I understand that a medical examination may be required to verify fitness to work and a pre-employment drug test may

be required after a job offer has been extended and prior to beginning work. Offers of employment are contingent upon

passing the pre-employment testing.

I understand and agree that if I am hired, my employment with Emera Maine will be terminable “at will.” As an at-

will employee, I understand and agree that I have the right to terminate my employment with Emera Maine at any time,

for any reason, with or without notice, with or without cause, and that Emera maine retains the same rights. If I am

hired, I understand that all benefits, policies, procedures and other terms and conditions of employment may be changed

by Emera Maine at any time, for any reason, with or without notice. I understand that this application form, any and

all policies, practices and procedures of Emera Maine, and all other communications provided or distributed to me by

Emera Maine, whether written or verbal, before hire or after I am employed, do not constitute or supplement any

contract of employment. I further understand that no agent, employee or representative of Emera Maine has the

authority to make any promise or agreement contrary to any of the foregoing, unless it is in writing and signed and

specifically authorized by the President of Emera Maine. If I am employed by Emera Maine, I promise to comply

with all policies, rules and regulations implemented by Emera Maine as set forth in Emera Maine’s policy manual or

other communications distributed to employees.

I understand that if I am hired, I must be able to furnish proof of my identity and eligibility to work in the United States

within 72 hours of employment (using forms of documentation deemed acceptable by the United States Citizenship and

Immigration Services). I understand that failure to provide such proof of identity and employment authorization will

result in my immediate discharge.

I hereby certify that the facts set forth in my employment application are true and complete to the best of my knowledge

and that I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that any

omissions or false or misleading statements in this application or in interviews or other aspects of the hiring process

may result in my disqualification from further consideration for employment or, if already employed, such information

may be grounds for immediate termination of my employment.

By signing below, I hereby acknowledge that I have read, agree to and accept the above terms and statements.

Emera Maine is an Equal Opportunity Employer

Signature of Applicant

Date

EMERA MAINE EMPLOYMENT APPLICATION FOR HUMAN

RESOURCE DEPARTMENT USE ONLY

Position (s) applied for is open:

Yes

Interviewed:

Yes

Position Considered For: Date:

Other Candidate Hired:

Position Not Filled:

Position Filled Internally:

Applicant Hired: Date: