SODEXO EMPLOYMENT APPLICATION APPLICATION FOR ...

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REQUIRED INFORMATION FOR CRIMINAL HISTORY CHECKAND/OR DRIVING RECORDS CHECKPLEASE PRINT LEGIBLY IN BLACK INKNAME OF EMPLOYEE / APPLICANT _____________________ ___________________ _________________________(FIRST) (MIDDLE) (LAST)SOCIAL SECURITY # _________ - _____ - _________ DATE OF BIRTH _____________ _____ _______________(MONTH) (DAY) (YEAR)HAVE YOU BEEN KNOWN BY ANY OTHER NAMES? YES NOIF YES, PLEASE LIST: __________________________________________________________________________1. CRIMINAL CONVICTION INFORMATIONIf you listed any criminal conviction information on the application (consistent with the state disclosure limitations), pleaseprovide the same information here.Date, place, nature of conviction(s):__________________________________________________________________________________________________________________________________________________________________________________________________________________2. ADDRESS INFORMATION—MUST BE COMPLETED BY ALL APPLICANTSYou must provide the following requested address information for all places you have lived for the past 10 years starting with yourcurrent residence:CITY/STATE/ZIP COUNTY (IF KNOWN) YEARS LIVED THERE(for example: From 2001 to 2004)_____________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ _____________________________________________________________________________ ____________________ ________________________3. DRIVING RECORD CHECK: Manager to initial if check is to be performed: ________(only if driving is a requirement of the position)If required, Applicant/Employee to complete the following:Driver’s License Number: ______________________________________ State ______ Expiration Date: _____________________Have you ever held a driver’s license in any other state?YES NOIf yes, please list the state(s) and dates (for example: New York, 2000-2003)_________________________________________________________________________________________________7 Revised 4/12
To:Subject:ApplicantRequest for Voluntary Self-IdentificationAs a government contractor, Sodexho is subject to governmental recordkeeping and reporting requirements tocomply with federal and state laws and regulations. Required reporting includes statistical accounting ofSodexho’s employment applicants with regard to sex, race and ethnic identification. Therefore, Sodexho requeststhat you voluntarily self-identify as requested below.The information you provide will be used exclusively for purposes consistent with applicable lawsand regulations.Submission of this information is voluntary and refusal to provide it will not subject you to any adversetreatment or impact any Sodexho employment decisions.Name:Initial: ______Applicant Self-Identification FormI do not wish to submit this information at this time.Sex: Male FemaleI. RACE/ ETHNIC IDENTIFICATION – PLEASE MARK ONLY ONE BELOW:Hispanic or Latino: A persons of Cuban, Mexican, Puerto Rican, South or Central American, orother Spanish culture or origin, regardless of race.a. If you did not check Hispanic or Latino above, please check one of the race categoriesbelow:American Indian or Alaska Native (Not Hispanic or Latino): A persons having origins in anyof the original peoples of North and South America (including Central America), and whomaintains tribal affiliation or community attachment.Asian (Not Hispanic or Latino): A person having origin in any of the original peoples of the FarEast, South east 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 (Not Hispanic or Latino): A person having origins in any of theblack racial groups of Africa.Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having originsin any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.White (Not Hispanic or Latino): 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 ofthe five races.If you have any questions regarding completion of this form, please speak to the Unit Manager or HumanResources representative.Form #85948Revised 01/07
Page 1: www.sodexoUSA.comAPPLICATION FOR EM
Page 4 and 5: EQUAL EMPLOYMENT OPPORTUNITY EMPLOY
Page 8 and 9: Applicant NotificationWork Opportun
Page 10 and 11: TO:FROM:RE:All ApplicantsDonna Alle
Page 12: Para informacion en espanol, visite

SODEXO EMPLOYMENT APPLICATION APPLICATION FOR ...

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