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Clean Energy Pathways Application

EMPLOYMENT APPLICATION INSTRUCTIONS: Individuals who need assistance with any phase of the application process should notify the person who referred them to the application to request a reasonable accommodation.

Important:

Complete the entire application (indicate “Not Applicable” for questions that do not apply to you).
Provide only requested information. Failure to do so may result in disqualification of your application.

Personal

First Name Last Name Home Address City State Zip Code Date of Birth Primary Phone Number Secondary Phone Number Email Address Preferred Contact Method Calls Texts Email Are you authorized to work in the United States? Yes No Emergency Contact Name Emergency Contact Relationship Emergency Contact Phone Number

Diversity and Inclusion

Diversity – We measure it because it matters

We are committed to being an Equal Opportunities Employer. We wish to ensure that all applicants are treated fairly and appointed solely on their suitability for the post irrespective of race, color, religion/belief, creed, nationality/national origin, ancestry, alienage or citizenship status, gender, sexual orientation, gender identity or expression, age, physical and/or mental disability, marital/civil partnership status, caring responsibilities, domestic violence victim status, veteran status, predisposing genetic characteristics or background. To help us measure how effective we have been in communicating with and attracting a diverse range of people to work with, you are requested to complete the following section.

We understand that some people would rather not answer these questions – either because they fear the information will be misused, or because they consider some of the questions to be highly personal. We would like to put your mind at rest. We can assure you that the information being given is kept separately from the information used in recruitment decisions. The information will not be used to influence recruitment decisions. All information is strictly confidential, PURELY for statistical purposes and to ensure that policies are being applied fairly; it will only be shared with a restricted number of authorized personnel. We will not discriminate against individuals who decide not to complete the form. However, we ask that as many people as possible agree to help us measure diversity – because it matters to us.

Which of the following best describes your race? Check all that apply. Black or African American Asian American or Pacific Islander Indigenous or Native American Caucasian or NonHispanic (White) Other I prefer not to specify Which of the following best describes your ethnicity? Hispanic or Latino Non-Hispanic I prefer not to specify Which of the following best describes your gender? Man Woman Non-Binary Genderqueer I prefer not to specify

Position

Please select which technician role you are applying for: Heating ventilation and air conditioning (HVAC) Weatherization This application is for a full-time internship (40 hours per week). Are you available from 8am – 5pm ET, Monday through Friday? Yes No

If applying for HVAC, have you completed training? Yes, I completed it I am currently enrolled No, I have not completed it

If Yes, from where did you graduate?

Most job in this industry start early. Are you available to begin work at a jobsite between 6:30 – 9:00 AM? Yes No When can you start?

Education

Highest level of education attained:

Work Experience

What is your previous employment and volunteer experience? (1000 Character Limit) Are you currently in school or working on a certification? Yes No If so, what is the certification?

References

Is a non-profit, community-based, or workforce development organization assisting you with this application? Yes No If so, which one? How did you hear about this opportunity?

Miscellaneous

Are you comfortable working as part of a team? Yes No Are you comfortable participating in training through online platforms such as Zoom or Microsoft Teams? Yes No Are you comfortable using public transportation to commute to and from training and work? Yes No This position often requires frequent travel around the region. Can you meet this requirement? Yes No Are you comfortable working in a house or commercial building? Yes No Do you have a valid driver’s license? Yes No If yes, do you have a car? Having a car is not required for this program. Yes No Are you willing and able to work in tight or confined spaces (E.G., crawlspaces, attics, basements)? Yes No Are you willing and able to climb ladders or work on rooftops? Yes No Are you prepared to complete the required trainings that are required to participate in this program? Yes No I am 18 years of age and can legally sign for myself.

Applicant acknowledgement

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.

I ACCEPT

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