EMPLOYMENT APPLICATION
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The name Black & Veatch is used on this application to signify Black & Veatch Holding Company, its subsidiaries and its affiliates.
*Provide country where you are
Currently located:
*First Name:
Middle Initial:
*Last Surname:
Suffix:
Preferred Name – First:
*Current Address 1:
*Current Town/City:
*Current County/State:
*Current Post Code:
*Current Country:
*Preferred Phone Number:
Alternate Phone Number:
*Preferred Personal Email
Address:
Mailing Address (Please complete the following section if different from address above.)
Mailing Address 1:
Mailing Town/City:
Mailing County/State:
Mailing Post Code:
Mailing Country:
Secondary School Education Information
Secondary School Name:
*Highest Grade Completed:
FIRSTCollege, University or Other Higher Education Information
College, University or Other
Higher Education Name:
Address:
Town/City:
County/State:
Post Code:
Level of Degree Received:
Major / Discipline:
GPA:
*Have you Graduated from Yes
This College, University or No
Other Higher Education?
Please list Year and Month of
Graduation in the following
Numeric format YYYY-MM:
SECONDCollege, University or Other Higher Education Information
College, University or Other
Higher Education Name:
Address:
Town/City:
County/State:
Post Code:
Level of Degree Received:
Major / Discipline:
GPA:
Status (Graduated or Currently
Attending):
Please list Year and Month of
Graduation in the following
Numeric format YYYY-MM:
Employment History
Please provide a minimum of seven years work experience or your last five employers.
If you were a contractor in any position(s) listed below, please provide the contracting firm’s information.
Current Employer Name:
CurrentEmployer Street
Address:
Current Employer Town/City:
Current Employer County/State:
Current Employer Post Code:
Current Employer Country:
Current Employer Phone
Number:
Current Job Title:
Name of Current Supervisor:
Title of Current Supervisor:
Start Date:
End Date:
Reason for Leaving:
May we contract your current Yes
Employer? No
Previous Employer 1:
Previous Employer Street
Address:
Previous Employer Town/City:
Previous Employer County/State:
Previous Employer Post Code:
Previous Employer Country:
Previous Employer Phone Number:
Previous Job Title:
Name of Previous Supervisor:
Title of Previous Supervisor:
Start Date:
End Date:
Reason for Leaving:
May be contact this previous employer? Yes
No
Previous Employer 2:
Previous Employer Street
Address:
Previous Employer Town/City:
Previous Employer County/State:
Previous Employer Post Code:
Previous Employer Country:
Previous Employer Phone Number:
Previous Job Title:
Name of Previous Supervisor:
Title of Previous Supervisor:
Start Date:
End Date:
Reason for Leaving:
May we contact this previous Yes
Employer? No
Previous Employer 3:
Previous Employer Address:
Previous Employer Town/City:
Previous Employer County/State:
Previous Employer Post Code:
Previous Employer Country:
Previous Employer Phone Number:
Previous Job Title:
Name of Previous Supervisor:
Title of Previous Supervisor:
Start Date:
End Date:
Reason for Leaving:
May we contact this previous employer? Yes
No
Previous Employer 4:
Previous Employer Address:
Previous Employer Town/City:
Previous Employer County/State:
Previous Employer Post Code:
Previous Employer Country:
Previous Employer Phone Number:
Previous Job Title:
Name of Previous Supervisor:
Title of Previous Supervisor:
Start Date:
End Date:
Reason for Leaving:
May we contact this previous employer? Yes
No
References
Please list three persons, preferably two former or current supervisors and/or peer, colleague or client, who can provide an in-depth professional reference.
If your only position within the last five years is self-employment, then please provide three business references.
Reference Name 1:
Phone Number:
E-Mail Address:
Reference Name 2:
Phone Number:
E-Mail Address:
Reference Name 3:
Phone Number:
E-Mail Address:
NEW PROFESSIONAL PROFILE FORM
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Welcome to Black & Veatch! We are excited you are coming aboard. The following information will be added to your personnel file. We ask you complete it thoroughly and accurately.
Personal Information
*Marital Status (select one): Married
Single
Divorced
Common-Law
Separated
Widowed
Unknown
*Gender (select one): Male
Female
*Date of Birth:
*Country of Birth:
*National ID Country:
*National ID Type:
*National ID Number:
*Citizenship Status:
Language Capability (other than English, fluent only)
Language:
Native Language: Yes
No
Able to Translate: Yes
No
Professional Organization Membership (relating directly to your position)
Organization Name:
Organization Membership Date:
Emergency Contacts (select only one as your primary contact)
NUMBER 1 Emergency Contact Name:
Is this your Primary Emergency Contact?
Emergency ContactRelationship:
Emergency ContactAddress:
Emergency ContactTown/City:
Emergency ContactCounty/State:
Emergency ContactPost Code:
Emergency ContactCountry:
Emergency ContactPhone Number:
Emergency ContactPhone Type:
Emergency ContactOther Phone Number:
NUMBER 2 Emergency Contact Name:
Is this your Primary Emergency Contact?
Emergency Contact Relationship:
Emergency Contact Address:
Emergency Contact Town/City:
Emergency Contact County/State:
Emergency Contact Post Code:
Emergency Contact Country:
Emergency Contact Phone Number:
Emergency Contact Phone Type:
Emergency Contact Other Phone Number:
By typing my name below, I certify that I have read this profile form and have voluntarily provided information. I understand that false statements made in any of these sections may be grounds for discharge.
*Signature (type name here)
*Today’s Date
Code of Conduct Acknowledgement
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You’re Commitment:
I agree that I have read this Code of Conduct and commit to conform to the standards in it as well as all supporting policies, practices and instructions as published and maintained by the company. I agree to the following concepts;
- In general, this Code defines how we operate. It is my duty, as well as that of each Black & Veatch professional, to thoroughly understand the prevailing standards, policies, practices and instructions that define the means and methods for conducting business and functioning effectively and efficiently as a member of the Black & Veatch team. This includes the need to periodically renew awareness of and knowledge about these standards, and the policies and practices that govern my roles and responsibilities.
- This Code defines important legal, governance and cultural tenets that have and will continue to contribute to the success of Black & Veatch.
- Failure to comply with any of these standards and supporting policies, practices and instructions increases the risks to Black & Veatch, its shareholders and stakeholders, including each professional.
Therefore, I am obligated, as is every professional, to report suspected failures of compliance and to fully cooperate with any investigation or review of such situations.
By typing my name below, I certify that I have read the aforementioned acknowledgements and agree with the statements set forth.
*Signature (type name here)
*Today’s Date
*Employee ID Number
Confidentiality and Patent Agreement
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Black & Veatch Holding Company, its subsidiaries and its affiliated companies, complies with all Equal Employment Opportunity (EEO) affirmative action laws and regulations.
As a professional of Black & Veatch, I may acquire access to confidential and proprietary information during the course of my employment.
I understand that it is my obligation to maintain the confidentiality of all such information and use it solely in the interest of B&V, both during and after my employment with B&V.
In consideration of my acceptance or continuation of employment with B&V, I agree as follows:
- I will not disclose or use for individual benefit any B&V proprietary or confidential information, data, or trade secrets during or following my employment with B&V, without the prior, written authorization of B&V, given by one of its officers.
Proprietary and confidential information includes all information that is not generally known and that could have value to a third party, including, but not limited to, financial reports, personnel data, business plans and strategies, engineering and business methods, procedures, standards, manuals, computer programs, process information, and process design methods, as well as information specifically designed by B&V or its clients as confidential.
- Inventions or discoveries that relate to business of B&V, whether patentable or not, are the property of B&V when made or conceived during my period of employment, whether made on B&V premises or during normal working hours or not.
I will inform my supervisor of any such inventions or discoveries promptly and fully, and I will assist B&V in obtaining covering patents related to inventions or discoveries if requested. Inventions or discoveries that do not relate to B&V business, including inventions or discoveries that arise through work on a post-graduate degree are excluded.
- Computers and the information stored thereon and other equipment supplied to me by B&V is the property of B&V and is to be returned when my employment with B&V ends.
If I fail to return B&V property, I authorize B&V to deduct the cost of such property from my final paycheck or other compensation due, or otherwise recover the cost from me.
- If I breach or attempt to breach any part of this Agreement, B&V shall be entitled to an injunction restraining such breach, reimbursement of any attorney fees expended in securing or enforcing the injunction, in addition to any other remedies it may have.
I agree and acknowledge that monetary damages and other forms of legal damages would be inadequate in the event of a breach of this Agreement.
- This Agreement shall be construed according to the laws of the State of Kansas.
By typing my name below, I certify that I have read the aforementioned acknowledgements and agree with the statements set forth.
*Signature (type name here)
*Today’s Date
*Employee ID Number
Policy Acknowledgement Form
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Equal Employment Opportunity and Non-Harassment Policy
I have received a copy of Black & Veatch’s Equal Employment Opportunity and Non-Harassment Policy.
I understand it is my responsibility to refrain from and report inappropriate conduct. I further understand how I may utilize Black & Veatch’s internal procedures for addressing my concerns or complaints regarding possible harassment or discrimination.
*I understand and Yes
acknowledge the need to No
comply with the Equal
Employment Opportunity and
Non-Harassment Policy.
Personnel Policies & Procedures Manual (PPPM)
I understand that I may access this manual on the Black & Veatch intranet once I begin employment with Black & Veatch.
If I am unable to access the Black & Veatch intranet, I may obtain information on policies and procedures contained in the PPPM from the EmployeeServiceCenter by calling 866-898-BVHR (2847).
I may contact the EmployeeServiceCenter with any questions or concerns I have regarding the policies and procedures. I further understand that compliance with Black & Veatch’s policies is a condition of my continued employment with Black & Veatch.
I understand that Black & Veatch may deduct from my paycheck any amounts that I owe to the company at any time during or after my employment, to the extent permitted by law.
Such deductions may include, but are not limited to, the value of any negative vacation balance owed to Black & Veatch if I leave the company.
My signature authorizes such deductions from my Black & Veatch paycheck. Any violation of policies set forth in the PPPM is subject to disciplinary action up to and including termination of employment.
*I understand and Yes
acknowledge the need to No
comply with the Personnel
Policies and Procedures
Manual (PPPM).
*Signature (type name here)
*Today’s Date
*= required field
The name black & Veatch is utilized on this form to signify Black & Veatch Holding
Company, its subsidiaries and its affiliates.