Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide 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:
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Cerebral Palsy
- Major depression
- Obsessive compulsive disorder
- Multiple sclerosis(MS)
- Impairments requiring the use of a wheelchair
- Missing limbs or partially missing limbs
- Intellectual disability (previously called mental retardation)
- Muscular dystrophy
- Reasonable Accommodation Notice
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a 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.
Our organization is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, sex, national origin, age, disability, or any other basis prohibited by federal, state, or local law. No question on this form is intended to secure information to be used for such discrimination. Submission of this information is voluntary; refusal to provide it will not subject you to any adverse treatment. Our organization is required by federal regulations to report information as requested below. Your contribution of this information is completely voluntary. The information you provide is strictly confidential and will be maintained separate from your application.
Government contractors/subcontractors subject to the Vietnam Era Veterans Readjustment Act of 1974 and the Rehabilitation Act of 1973 are required to take affirmative action to employ and advance in employment recently separated veterans, active duty wartime or campaign badge veterans, Armed Forces service medal veterans, disabled veterans and qualified individuals with a disability. The information provided will be held in the strictest confidence, will be maintained separate from your application, and will not be used in a manner inconsistent with the Acts.
Armed Forces Service Medal Veteran
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.
Recently Separated Veteran
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.
Active Duty Wartime or Campaign Badge Veteran
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.
A "disabled veteran" is one of the following:
- A veteran of the U.S. military, ground, naval or air force 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 Sec'y of Veteran Affairs, or
- A person who was discharged or released from active duty because of a service-connected disability.
If you are an individual with a disability or a disabled veteran, feel free to inform us of (1) any special methods, skills and procedures which qualify you for positions that you might not otherwise be able to perform because of your disability so that you may be considered for any position of that kind, and (2) reasonable accommodations which you would propose to assist you in performing the job properly and safely.
Resume / Cover Letter
Please provide your resume and/or cover letter in PDF or Word DOC format.
Accepted file types: pdf, doc, docx.
Accepted file types: pdf, doc, docx.
The above information is true and complete to the best of my knowledge. Should I be employed by The Kraemer Company, any misrepresentation or false statement contained herein may be considered cause for possible dismissal. The Kraemer Company has my permission to obtain all necessary information from the references I have listed, or any other sources, concerning my prior employment, personal history or credit standing and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice to me. I reserve the right to know the names and addresses of any investigative agencies used in order that I may learn the information contained in any reports furnished to The Kraemer Company.
I also understand that certain positions at The Kraemer Company may require completion of a drug screen prior to employment, that employment is contingent on a satisfactory drug screen result, and that I may be required to complete a medical exam after employment. The Kraemer Company maintains a smoke-free environment and prohibits smoking in company buildings, shops and field offices.
I understand that this application does not constitute an employment contract of any kind. Should I be employed by The Kraemer Company, I may resign such employment at any time at my discretion with or without prior notice, and The Kraemer Company may terminate my employment at any time at their discretion, with or without cause and with or without prior notice.
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