chc mechanical contractorsMechanical ContractingCommercial ServicesDesignBuild
latest news
CHC Mechanical named Tennessee’s safest specialty contractor
read more >

347 East Stevens Street
Cookeville, TN 38501
PHONE: (931) 528-5514

CHC MECHANICAL CONTRACTORS, INC.
EQUAL EMPLOYMENT OPPORTUNITY SELF-IDENTIFICATION FORM

To the Applicant:

CHC Mechanical Contractors is committed to equal employment opportunity and affirmative action. The Company is required by the U.S. Department of Labor to request and maintain the following data on all applicants for employment with the Company. This information will be used for statistical summaries of employment practices, and to monitor the Company’s compliance with equal employment opportunity requirements. Your voluntary return of this form is encouraged.

TO BE COMPLETED BY THE APPLICANT:

1. SPECIFIC POSITION APPLIED FOR:

2. DEPARTMENT OR LOCATION:

3. APPLICANT’S NAME:

4. SEX (check one):
  Male
  Female
5. RACE:

  White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

  Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race

  Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.

  Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

  Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

  American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

  Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above races.

6. SOURCE OF POSITION INFORMATION:

From what source did you learn of this position?

If by advertisement, please name publication:  

The Company is a Government contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended, which requires Government contractors to take affirmative action to employ and advance in employment qualified special disabled veterans and veterans of the Vietnam era.

If you are a veteran of the Vietnam era, we would like to include you under our affirmative action program. If you would like to be included under the affirmative action program, please tell us. The term “Vietnam Era Veteran” refers to a person who served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred in the Republic of Vietnam between February 28, 1961, and May 7, 1975 or between August 5, 1964, and May 7, 1975, in all other cases. The term also refers to a person who was discharged or released from active duty for a service-connected disability if any part of such active duty was performed in the Republic of Vietnam between February 28, 1961, and May 7, 1975, or between August 5, 1964, and May 7, 1975, in all other cases.

“Other Eligible Veterans” means (A) a veteran that served in a “war” such as the Korean War or (B) those veterans who served in a campaign or on an expedition for which a campaign badge, a service medal, or an expeditionary medal has been awarded, such as Operation Enduring Freedom or Operation Iraqi Freedom.


7. MILITARY VETERAN STATUS (Check if applicable):

Vietnam Era Veteran (February 28, 1961 - May 7, 1975):     Yes      No 

Other Eligible Veteran:     Yes      No 
     If “yes”, please list war, campaign or expedition: