Sunrise Safety Services, Inc. is an Equal Opportunity Employer
For assistance with this application, you may apply in person.
Reasonable accommodations provided upon request and as required by law.
Fill out and submit the form below and a representative will contact you.
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List previous employers - Current employer first.
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Carefully read each statement before signing at the bottom
I understand and agree that Sunrise Safety Services, Inc. may request without prior notification or warning, a Drug
screening to be performed for Pre-Employment testing, or if employed, a random screening at any time during my
Driving Record Release
Sunrise Safety Services requires an MVA Driver's Record when considering me for employment. I authorize the MVA
to release that information to Sunrise Safety Services, Inc. This release is valid as long as I am an employee or
employee candidate and may only be rescinded in writing.
Authorization for MVA Review
I understand that as a potential driver of a company vehicle, it will be my responsibility to operate the vehicle in a
safe manner and to drive defensively to prevent injuries and property damage. I also understand that, if employed
by Sunrise Safety Services, Inc., my Motor Vehicle Record will be periodically reviewed to determine my continued
eligibility to drive a company vehicle. In accordance with the Fair Credit Reporting Act, I have been informed that a
Motor Vehicle Record will be periodically obtained on me for continued employment purposes.
I acknowledge that I have read the disclosure and authorize Sunrise or its designated agent to obtain a Motor Vehicle
Record report. This authorization is valid as long as I am an employee or employee candidate and may only be
rescinded in writing.
Driver's License Number
I certify that all of the information provided in this employment application is true and complete to the best of my
knowledge, and I authorize investigation of all statements contained in this application, including a criminal
background, drug test, and credit history check (if applicable for position). I understand that any false or incomplete
information may disqualify me from further consideration for employment and may result in my immediate
discharge if discovered at a later date.
I authorize the investigation of any or all statements contained in this application and also authorize any person,
school, current employer, past employers, and other organizations to provide information concerning my previous
employment and other relevant information that may be useful in making a hiring decision. I release such persons
and organizations from any legal liability in making such statements. I also understand and agree that no
representative of the company has any authority to enter into any agreement for employment for any specified
period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized
I understand that employment with Sunrise is at will, so that both Sunrise and I remain free to choose to end our
work relationship at any time, with or without cause, and with or without prior notice.
THE REHABILITATION ACT OF 1973 AND THE VIETNAM ERA VETERAN'S READJUSTMENT ASSISTANCE ACT OF 1974 VOLUNTARY DISCLOSURE FORM
Sunrise Safety Services, Inc. employees are treated during employment without regard to race, religion, color, sex, national origin, age, disability or veteran status. We invite you to answer the questions below. Submission of this information is voluntary. A decision not to provide it will not subject you to any adverse treatment. All information will be kept confidential and will be used in accordance with applicable laws and regulations.
DISABLED - I am a qualified disabled person, i.e. I have a physical or mental impairment which substantially limits one or more of those major life activities which affects my employability. I have a record of such impairment or I am regarded as having such impairment.
A DISABLED VETERAN - I am a qualified disabled veteran, i.e. I am entitled to a disability compensation underthe laws administered by the Veterans Administration for a disability orated at 30% or more OR I was discharged or released from active duty for a disability incurred or aggravated in the line of duty.
A VIETNAM ERA VETERAN - I am a veteran of the Vietnam Era, i.e. I served on active duty for more than 300days, any part of which occurred between August 5, 1964 thru May 7 1975, and I was discharged with other than a dishonorable discharge; or I was discharged or released from active duty for a service-connected disability during the same period.
VOLUNTARY SELF-IDENTIFICATION FORM
Sunrise Safety Services, Inc. is an equal opportunity employer that is committed to a program of recruiting females and minority group members. In order to help us to comply with government record keeping, reporting and other legal requirements we ask that you complete this form. The information will not be used in evaluating your application for employment. Completion of this form is voluntary
How did you learn about Sunrise Safety and/or the position (please check all that apply):
Referred by Sunrise Employee
Referred by my School
Unsolicited walk-in, resume or application
Other (please explain)
Alaskan Native Black Native American Asian Pacific Hispanic White Other
I have read, understand, and agree to all of the above statements.