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Open Positions

DLC Employment Application

Name*

First Middle Last

Email | Phone | Address

Current Address*

Street Address Address Line 2 City State ZIP Code

Business Phone

Home Phone

Mobile Phone

Email*

Availability | Desired Salary

Are you available for work on weekends?*

Yes

Would you be available to work overtime, if necessary?*

Yes

If hired, on what date can you start?*

MM slash DD slash YYYY

Base Salary Desired*

Personal Information

Have you ever applied to work for DLC before?*

Yes

If yes, when?*

Do you have any friends or relatives working for DLC?*

Yes

Friend/Family Working at DLC

Name	Relationship	Actions

There are no Friends/Relatives.

Maximum number of friends/relatives reached.

Were you referred by an internal employee?*

Yes

Please indicate name.*

Why are you applying for work at DLC?*

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?*

Yes

If hired, would you have a reliable means of transportation to and from work?*

Yes

Are you at least 18 years old? (If under 18, hire is subject to verification that you are a minimum legal age.)*

Yes

Are you able to perform the essential functions of the job for which you are applying either with or without reasonable accommodation?*

Yes

If no, describe the functions that cannot be performed.*

Are you currently employed?*

Yes

Education, Training, and Experience

College/University	Degree Awarded	Actions

There are no Entries.

Maximum number of entries reached.

Undergraduate

Education, Training, and Experience

College/University	Degree Awarded	Actions

There are no Entries.

Maximum number of entries reached.

Certification

Are you a licensed CPA or Chartered Accountant?*

Yes

License/Certification #*

Issuing State*

Has your license ever been revoked or suspended?*

Yes

If yes, state reason(s), date of revocation or suspension, and date of reinstatement.*

Employment History

List below all present and past employment starting with your most recent employer (last five years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume.

Employment History

Name	Phone	utm_campaign	utm_medium	Actions

There are no Entries.

Maximum number of entries reached.

References

Please provide references as specified below:

A minimum of 2 Direct Supervisors within the last 5-7 years.
A minimum of 2 Peers and/or Superiors in other cross-functional areas familiar with your work.
If appropriate, 1 or more subordinates at a professional level.

For each reference, please include the name, contact information, title, their relationship to your role, and the length of your acquaintance. Please contact your references and give them a “heads-up”.

Reference

Company Supervisor Address To Actions

There are no Entries.

Maximum number of entries reached.

Consent*
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.*

Consent*
I hereby authorize DLC to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.*

Consent*
Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.*

I waive receipt of a copy of any public record described in the paragraph above.*
I waive receipt of a copy of any public record described in the paragraph above.*

Consent*
I understand that if I am hired, a client may require me to prove I have received the COVID-19 vaccine, or the client may choose to consider a vaccination exemption if I can prove a sincerely held religious belief or valid medical reason not to be vaccinated. Reasonable accommodations will be considered if an exemption is requested. These will be considered on a case-by-case basis*

DISCLOSURE TO JOB APPLICANTS PURSUANT TO THE CALIFORNIA CONSUMER PRIVACY ACT (CCPA)*
DISCLOSURE TO JOB APPLICANTS PURSUANT TO THE CALIFORNIA CONSUMER PRIVACY ACT (CCPA)

As part of your job application and DLC, Inc’s evaluation of your candidacy, DLC, Inc collects, receives, maintains, and uses the following types of Personal Information about you for the business purposes identified for each category:

Category: Personal Identifiers
Examples: Name, alias, postal or mailing address, email address, telephone number, social security number, driver’s license or state identification card number, passport number
Business Purpose:
1. To comply with state and federal law and regulations requiring; employers to maintain certain records;
2. To evaluate your job application and candidacy for employment;
3. To obtain and verify background check and references; and
4. To communicate with you regarding your candidacy for employment.
5. To provide a client company with sufficient information to determine whether to retain your services for a project or program.

Category: Pre-Hire Information
Examples: Job application, resume, background check results, drug test results, job interview notes, and candidate evaluation records
Business Purpose:
1. To comply with state and federal law and regulations requiring; employers to maintain certain records;
2. To evaluate your job application and candidacy for employment;
3. To obtain and verify background check and references; and
4. To communicate with you regarding your candidacy for employment.
5. To provide a client company with sufficient information to determine whether to retain your services for a project or program.

Category: Employment History
Examples: Information regarding prior job experience, positions held, names of prior supervisors, and when permitted by applicable law your salary history or expectations
Business Purpose:
1. To comply with state and federal law and regulations requiring; employers to maintain certain records;
2. To evaluate your job application and candidacy for employment;
3. To obtain and verify background check and references; and
4. To communicate with you regarding your candidacy for employment.
5. To provide a client company with sufficient information to determine whether to retain your services for a project or program.

Category: Education Information
Examples: Information from resumes regarding educational history; transcripts or records of degrees and vocational certifications obtained
Business Purpose:
1. To comply with state and federal law and regulations requiring; employers to maintain certain records;
2. To evaluate your job application and candidacy for employment;
3. To obtain and verify background check and references; and
4. To communicate with you regarding your candidacy for employment.
5. To provide a client company with sufficient information to determine whether to retain your services for a project or program.

Except as set forth above, DLC, Inc does not share personal information with any third party. If you become employed by DLC, Inc you will be notified of additional categories of Personal Information that it collects, receives, and maintains for business purposes.
I acknowledge and confirm that I have received and read and understand this disclosure; and I hereby authorize and consent to the Company’s use of the personal information it collects, receives or maintains for the business purposes identified above.

Signature*

DLC, an Addison Group Company, is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

Email
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