Apply for General Application

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

If you are an applicant in need of assistance or an accommodation in the Application Process please email Applications@blakleys.com or call
317-576-8347.

Summary
Title:General Application
ID:2060
Department:Administrative
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Home Phone:
Mobile Phone:
* Email:
* Social Security #:
Previous Name:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Blakley's Application for Employment
APPLICANT NOTE
Blakley's is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, qualified veteran status, or disability.
*
I understand that Blakley's uses the E-Verify system.

PERSONAL INFORMATION
* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment):
Yes   No
* Are you at least 18 years or older? (If no, you may be required to provide authorization to work):
Yes   No
* Have you ever been convicted of a felony or a misdemeanor that has not been legally expunged or removed for your record which resulted in imprisonment within the last seven years? (A conviction will not necessarily result in the denial of employment):
Yes   No
If Yes, please explain:
* Have you ever worked for this Company before?:
Yes   No
If Yes, please provide details (Where/When/Job Title):
* Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?:
Yes   No
If no, please explain:

EMPLOYMENT DESIRED
* When would you be available to begin work?:
* Type of employment desired:
Full-Time
Part Time
Seasonal
* Hourly rate/salary desired:
* Are you currently employed?:
Yes   No
If so may we inquire of your present employer?:
Yes   No
If presently employed, why are you considering leaving?:

EDUCATION
* Have you completed high school or GED equivalent?:
Yes   No
* Have you completed a 4 year college program?:
Yes   No

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location Did you Graduate? Degree Received Subjects Studied/Major
Yes   No
Yes   No
Yes   No

If you have completed any special courses, seminars and/or training that would help you to perform the position for which you are applying, please describe:

EMPLOYMENT HISTORY
Give your full employment record, starting with your current or most recent employment. Please complete this section in detail to be considered for this position. You will be contacted if a cover letter or resume is requested.

EMPLOYER 1

Dates Employed Employer Name & Address Employer Phone
From:
*

To:
*
*

*
*
Job Title Supervisor Name & Title May we Contact?
*
*

*
*
Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
*
*
Start:
*

End:
*

EMPLOYER 2

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:

EMPLOYER 3

Dates Employed Employer Name & Address Employer Phone
From:

To:

Job Title Supervisor Name & Title May we Contact?

Yes
No
Responsibilities Reason for Leaving Salary/Hourly Rate
Start:

End:

REFERENCES Please provide three references (not relatives).

Name Relationship Phone Number

AUTHORIZATION
The facts set forth in this application and any supplemental information is true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

* Signature (type name):
* Date:
Referral Source
* Please Select How You Were Referred to Blakley's.:
Employment Agency
Temporary Agency
National Advertisement/ Search
Local Advertisement
College Grad/School
Job Fair/ Open House
Outreach-minority
Vocational/ Rehabilitation Facility
Blakley's Recruiter
Local High School
Job Hotline
Walk-in
Internet
Outreach-disabled veteran
State Employment Agency
Employee Referral
Union Other
Union Tile Setter
Union Glazer
Union Bricklayer
Other
If you answered, employee referral, please state name of person that referred you.
If you answered, Union, please state which local you are affiliated with.
If you answered Union, please state which organization referred you to the Union?
Veterans Self-Identification Form
1. This employer is a Government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined as follows:
  • DISABLED VETERAN is either (1) 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 (2) a person who was discharged or released from active duty because of a service-connected disability.
  • RECENTLY SEPARATED VETERAN is 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 is 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.
  • ARMED FORCES SERVICE MEDAL VETERAN is 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.

Protected veterans may have additional rights under USERRA - the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service, toll-free, at 1-866-4-USA-DOL.

2. As a Government contractor subject to VEVRAA, we are required to submit a report to the United States Department of Labor each year identifying the number of our employees belonging to each specified "protected veteran" category. If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the VEVRAA.
I belong to the following classifications of protected veterans (choose all that apply)::
Disabled Veteran
Recently Separated Veteran
Active Wartime or Campaign Badge Veteran
Armed Forces Service Medal Veteran
I am a protected veteran, but I choose not to self-identify the classifications to which I belong.
I am NOT a protected veteran.
I don't wish to answer.

If you are a disabled veteran it would assist us if you tell us whether there are accommodations we could make that would enable you to perform the essential functions of the job, including special equipment, changes in the physical layout of the job, changes in the way the job is customarily performed, provision of personal assistance services or other accommodations. This information will assist us in making reasonable accommodations for your disability.

3. The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed, when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

* Signature (type name): * Date:
2020 - Voluntary Self-Identification of Disability CC-305

Voluntary Self-Identification of Disability

Form CC-305
Page 1 of 1
OMB Control Number 1250-0005
Expires 05/31/2023
Name:
Employee ID:
(if applicable)
Date:

Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified peoplewith disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individualswith disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.
Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you 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:
  • Autism
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
  • Blind or low vision
  • Cancer
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or hard of hearing
  • Depression or anxiety
  • Diabetes
  • Epilepsy
  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
  • Intellectual disability
  • Missing limbs or partially missing limbs
  • Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)
  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

Please check one of the boxes below:

Yes, I Have A Disability, Or Have A History/Record Of Having A Disability
No, I Don’t Have A Disability, Or A History/Record Of Having A Disability
I Don’t Wish To Answer
 
PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
 
For Employer Use Only
Employers may modify this section of the form as needed for recordkeeping purposes.

For example:
Job Title:
Date of Hire:
VEVRAA
This employer is a government contractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1874, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires government contractors to take affirmative action to employ and advance in employment: (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans. These classifications are defined below:

"Disabled veteran" is one of the following:
  • Veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
  • Person who was discharged or released from active duty because of a service-connected disability
"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" 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.

"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.

Protected veterans may have additional rights under USERAA - the Uniformed Services Employment and Reemployment Rights Act. In particular, if you were absent from employment in order to perform service in the uniformed service, you may be entitled to be reemployed by your employer in the position you would have obtained with reasonable certainty if not for the absence due to service. For more information, call the U.S. Department of Labor's Veterans Employment and Training Service (VETS), toll free, at 1-866-4-USA-DOL.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a Government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.

I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERANS LISTED ABOVE
I AM NOT A PROTECTED VETERAN

Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are not inconsistent with the Vietnam Era Veteran’s Readjustment Assistance Act of 1974, as amended.

The information you submit will be kept confidential, except that (i) supervisors and managers may be informed regarding restrictions on the work or duties of disabled veterans, and regarding necessary accommodations; (ii) first aid and safety personnel may be informed , when and to the extent appropriate, if you have a condition that might require emergency treatment; and (iii) Government officials engaged in enforcing laws administered by the Office of Federal Contract Compliance Programs, or enforcing the Americans with Disabilities Act, may be informed.

Equal Opportunity Employer Pre-Offer
It is the policy of The Blakley Corporation that there shall be no discrimination in employment ( including recruiting, hiring, promotion, compensation, and any other condition, or privilege of employment) on the basis of status as a disabled veteran, Vietnam era veteran ( as defined in 38USC Sec. 4211 41 CFR 60-250) or as a veteran who has served on active duty during a war or in an active campaign or expedition for which a campaign badge has been authorized, with regard to any position for which such individual may be qualified. This policy is intended to be in compliance with The Blakley Corporation's obligation as a federal contractor under The Vietnam Era Veteran's Readjustment Assistance Act, specifically 38 USC Sec. 4212, and it's implementing regulations, 41 CFR 60-250.

It is this Company's policy to provide equal employment opportunities to all employees in accordance with all applicable laws, directives and regulations of federal, state and local government bodies. It is out policy to recruit, hire, train and promote individuals in all employment positions without regard to race, color, religion, sex, national origin, age, veteran status or disability.

The following information is being requested so that we may comply with the law and our Equal Employment Opportunity Policy. COMPLETION OF THIS SECTION IS VOLUNTARY. No adverse treatment will result from your refusal to provide this information. This information will only be used for statistical analyses and compliance reporting. It will not be placed in your personnel file.

* Gender:
Male
Female
I Choose Not to Respond

* Race / Ethnicity:
American Indian or Alaska Native (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Hispanic or Latino
Asian (Not Hispanic or Latino)
White (Not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)
Two or More Races (Not Hispanic or Latino)
I Choose Not to Respond


ApplicantStack powered by Swipeclock