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Equal Opportunity
J-U-B ENGINEERS, Inc. is an Equal Opportunity Employer. We are a company that values diversity. We actively encourage women and minorities to apply. As required by Federal law and as a part of our Affirmative Action Program, we must gather statistical information and maintain accurate recruitment and selection data to ensure Equal Employment Opportunity.

Your voluntary responses will remain confidential and will not become part of your employment application. Thank you for your cooperation!
Ethnicity/Race: Please check box with which you identify. See Definition
ETHNICITY/RACE DEFINITIONS:
- American Indian or Alaskan Native: a person having origins in any of the original peoples of North and South America (including Central America) and who maintain tribal affiliation or has community recognition as an American Indian or Alaska Native.
- Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including for example: Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
- Black or African American: a person having origins in any of the black racial groups of Africa.
- Hispanic or Latino Origin: a person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin regardless of race.
- Native Hawaiian or Other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
- White: a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
- Two or More Races (Not Hispanic or Latino): all persons who identify with more than one of the above categories.
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Gender: Please check the box with which you identify.
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Veteran Status: Please check box with which you identify. See Definition
VETERAN DEFINITION:
- A “Vietnam-Era Veteran” mean a person who:
  - Served on active duty for more than 180 days AND was discharged or released from the military where any part of your active duty was performed (a) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (b) in any other part of the world between August 5, 1964 and May 7, 1975. OR
  - Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed (a) in the Republic of Vietnam between February 28, 1961 and May 7, 1975; or (b) in any other part of the world between August 5, 1964 and May 7, 1975.
- 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.
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Do you have a disability or previously had a disability? See Definition

DISABILITY DEFINITION:

Individual with Disabilities Defined as a person who (1) has a physical or mental impairment which substantially limits one or more of his or her major life activity(s), (2) has a record of such impairment(s), or (3) is regarded as having such impairment(s).

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Have you applied with JUB within the past 30 days?*
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- Yes, skip application
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Personal Information
Evening Phone
Other Phone
Street Address*
Street Address City State / Province / Region ZIP / Postal Code
Date Available
MM slash DD slash YYYY
Are you able to perform all of the job duties as described with or without reasonable accommodations?*
- Yes
- No
If No, please describe the functions that cannot be performed:
Are you legally eligible for employment in the United States?*
- Yes
- No
Are you subject to a non-compete or other agreement with your current employer that may restrict your ability to perform work for J-U-B? (if yes please provide a copy of the agreement)*
- Yes
- No
Do you have any friends, relatives, or acquaintances working for the company?
- Yes
- No
If yes, state Name & Relationship

Education Information
School
Location
Course of Study
Diploma / Degree
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School
Location
Course of Study
Diploma / Degree
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School
Location
Course of Study
Diploma / Degree

Professional Status and/or License / Registration / Certification
List all professional registrations and certifications including, but not limited to, professional engineer, structural engineer, engineer-in-training, professional traffic operations engineer, professional land surveyor, land surveyor-in-training , or others.
List all professional registrations and certifications including, but not limited to, professional engineer, structural engineer, engineer-in-training, professional traffic operations engineer, professional land surveyor, land surveyor-in-training , or others.
Registration/Certification State License Number Date Granted
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Professional Affiliations
List professional organization memberships (including leadership positions), that are pertinent to the position. (Exclude those which indicate age, race, color, sex, religion, national origin, or disability)
List professional organization memberships (including leadership positions), that are pertinent to the position. (Exclude those which indicate age, race, color, sex, religion, national origin, or disability)
Professional Organization
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Professional Papers/Awards
List professional papers, publications, and/or awards that are pertinent to the position
List professional papers, publications, and/or awards that are pertinent to the position
Title
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Experience / Specialized Training / Skills
Complete the following (where applicable) to describe training, experience, knowledge, and/or ability.
Engineering / Technical Positions
Computer applications / Equipment / Programming / Languages, etc.
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Land Surveying Positions
Office computation, Plotting, Drafting Applications / Equipment, etc.
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Office / Clerial Positions
Computer Applications, Office Equipment, etc.
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Employment History
GIVE ACCURATE AND COMPLETE EMPLOYMENT HISTORY, INCLUDING FULL AND PART-TIME JOBS. PLEASE START WITH CURRENT OR MOST RECENT EMPLOYER.
Company
From
To
Street Address
City
State
Zip Code
Title
Department
Supervisor
Duties
Reason for Leaving
May we Contact this employer?
- Yes
- No
- add more employment

Employment History
Company
From
To
Street Address
City
State
Zip Code
Title
Department
Supervisor
Duties
Reason for Leaving
May we Contact this employer?
- Yes
- No
- add more employment

Employment History
Company
From
To
Street Address
City
State
Zip Code
Title
Department
Supervisor
Duties
Reason for Leaving
May we Contact this employer?
- Yes
- No
- add more employment

Employment History
Company
From
To
Street Address
City
State
Zip Code
Title
Department
Supervisor
Duties
Reason for Leaving
May we Contact this employer?
- Yes
- No

References
Please list three professional references, excluding former employers or relatives.
Please list three professional references, excluding former employers or relatives.
Name Occupation Address Phone
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Applicant's Certification and Agreement
I hereby affirm and declare that all the foregoing statements are true and correct, and that I have not knowingly withheld any fact that would, if disclosed, affect my application unfavorably. I understand and agree that any omission, false statement, misleading statement, or answer made by me on my application or any supplements to it and in any interviews will be sufficient cause for rejection of employment and discharge if already employed by J-U-B.

By carefully reviewing and signing a Disclosure and Authorization Form to obtain a background check for employment purposes, I have authorized J-U-B or its agents to conduct any investigation it deems necessary. I also hereby authorize J-U-B to release such information, together with its opinions on these matters, without any liability for any damage whatsoever caused either directly or indirectly by giving or receiving this information or opinions. I authorize my former and present employers and personal references to give any information they may have concerning my character and employment record.

I understand that employment is at the will and for the convenience of J-U-B, which means either the company or I can terminate the employment relationship at any time, for any reason, and with or without notice. I understand that employee policies adopted by J-U-B shall in no way be interpreted as creating an employment contract or a relationship that is other than an at-will employment relationship.

I acknowledge that final employment will be per the terms of the:
- Offer Letter,
- J-U-B’s Employee Handbook, and
- J-U-B’s Benefit Plan Documents.
Signature of Applicant*
*By typing my name in the signature box, I understand this constitutes a legal signature and I agree to the terms listed above.
Date*
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Email
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Application Information

Equal Opportunity

Ethnicity/Race: Please check box with which you identify. See Definition

Gender: Please check the box with which you identify.

Veteran Status: Please check box with which you identify. See Definition

Do you have a disability or previously had a disability? See Definition

Personal Information

Education Information

Professional Status and/or License / Registration / Certification

Professional Affiliations

Professional Papers/Awards

Experience / Specialized Training / Skills

Employment History

Employment History

Employment History

Employment History

References

Applicant's Certification and Agreement

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