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Public Hearing Scheduled for Monday, November 25, 2019 Read More »
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Rock Creek Community Meeting Updates - August 2019 Read More »
Sewer-related emergency? Read More »

Affirmative Action Form

We consider all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve/national guard or any other similarly protected status. We also comply with all applicable laws governing employment practices and do not discriminate on the basis of any unlawful criteria.

We are an at-will employer, meaning that either the employer or the employee may end the employment relationship at any time and for any or no reason.

This form is to be completed by the applicant on a voluntary basis. This form will not be used for interview purposes and will be filed separately from the employment application.

In an effort to comply with requirements regarding government record keeping, reporting, and other legal obligations which may apply, we invite you to complete this applicant data survey. Providing this information is STRICTLY VOLUNTARY. Failure to provide it will not subject you to any adverse personnel decision or action. Your cooperation is appreciated.

Please be advised that this survey is not a part of your official application for employment. It will not be used in any hiring decision. The information will be used and kept confidential in accordance with applicable laws and regulations.

Name: *
Today's Date: *
Position Applied For: *
Referral Source: *
Advertisement
Internet
Word of Mouth
Employee
Friend or Relative
Race: *
Hispanic or Latino
White (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Asian or Other Pacific Islander (Not Hispanic or Latino)
American Indian or Alaska Native (Not Hispanic or Latino)
Two or More Races (Not Hispanic or Latino)
Gender: *
Male
Female
Background Check Information: Current Name *
Background Check Information: Do you have a former name? *
Yes
No
Background Check Information: Former Name & Dates Used
Background Check Information: Current Address Since *
Background Check Information: Previous Address From
Background Check Information: Previous Address From
Background Check Information: Social Security Number *
Background Check Information: Date of Birth *
Background Check Information: Driver's License Number/State *
The Information contained in this application is correct to the best of my knowledge. *
Yes
No
Background Check Information: Digital Signature & Last Four Digits of Social Security Number *

I hereby authorize Renewable Water Resources (ReWa) and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit report, current and previous residences; current and previous employment history, education background, character references, drug testing, pre-employment physical, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth record, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or writing, pertaining to me, to Renewable Water Resources (ReWa) or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Renewable Water Resources (ReWa) and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant’s personal information, including, but not limited to, addresses, social security number, and date of birth.