ADD Application First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human? First Name Last Name Phone Format: 2254445555 Email address City State/Territory ZIP/Postal Country Are you willing and capable of working on an international assignment? Yes No Upload Resume & Documents (optional) Upload your resume or any other relevant file. Upload Certificates or Training Documents (optional) (optional) Maximum file size: 50 MB. Desired Employment Type? FULL TIME PART TIME TEMPORARY Are you currently employed? YES NO If hired when could you start work? Format: MM/DD/YYYY Are you 18 years of age or older? YES NO 18 Years or Older: Are you legally authorized to work in the United States? YES NO Do you now or will you in the future require immigration sponsorship (e.g. H-1B)? YES NO Have you ever applied here before? YES NO If Yes please specify when. (optional) Format: MM/DD/YYYY Were you ever employed here? YES NO If Yes specify title location and dates of employment. (optional) During the past seven years have you ever been discharged suspended or asked to resign from any position? YES NO If yes please explain below. (optional) Please list any additional job related training or certifications. (optional) Education School Name School Type High School/GED College/University Vocational/Technical Degree/Certificate High School Diploma/GED Trade or Technical School Diploma Associates Degree Bachelors Degree PhD Other Other Degree/Certificate (optional) Credit Hours Completed (optional) Current or Most Recent Employment Employer Name City/State/Zip Position/Title Date From Format: MM/YYYY Date To Format: MM/YYYY Responsibilities & Duties OK to Contact? YES NO Supervisor Name (optional) Supervisor Phone (optional) Format: 2254445555 Reason for Leaving? (optional) Questions 1. Do you have any Nuclear / Fossil Power Maintenance experience? If so please describe. 2. Do you have recent management experience? If so please describe scope of duties and number of employees you supervised. * 3. Please list any professional certificates that you have earned and where they were obtained. 4. Where did you hear about this position? (If from a personal referral please tell us who) * 5. This position may require night weekend holiday and/or overtime work depending on the job sites operation schedule. Are you willing and able to work this schedule? YES NO Please check any additional job related training or certifications. (optional) nMap EPRI ExUtility NANTEL WANO Radworker INPO Utility Qualifications Valve Training Welding Certifications State Licenses Other Select Voluntary Self-Identification of Equal Opportunity Status: The federal government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment. Submission of information is purely voluntary and our cooperation is appreciated. Charah, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Charah, Inc. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Charah, Inc. expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Charah’s employees to perform their job duties may result in discipline up to and including discharge. Gender Male Female Choose Not to Disclose Race/Ethnic Group Hispanic or Latino White (not Hispanic or Latino) Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaskan Native Two or More Races Choose Not to Disclose Voluntary Self-Identification of Veterans Status This employer is a Government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act of 1974, 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 as follows: A “disabled veteran” is one of the following: 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 a person who was discharged or released from active duty because of a service-connected disability. A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veterans discharge or release from active duty in the U.S. military, ground, naval, or air service. An “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. An “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 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 Labors 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 making the appropriate selection 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. You can select all that apply by holding CTRL and clicking the appropriate selections. Any information provided is voluntary and will not be not be used in any fashion that is inconsistent with this act. Veteran/Disability: * I am not a protected veteran Disabled Veteran Recently Separated Veteran Active Wartime or Campaign Badge Veteran Armed Forces Service Medal Veteran I am a protected veteran, but choose not to self-identify by classification Choose Not to Disclose Voluntary Self-Identification of Disability Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. How do I know if I 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: • Blindness • Cerebral palsy • Multiple sclerosis (MS) • Deafness • HIV/AIDS • Missing limbs or partially missing limbs • Cancer • Schizophrenia • Post-traumatic stress disorder (PTSD) • Diabetes • Major depression • Obsessive compulsive disorder • Epilepsy • Bipolar disorder • Impairments requiring the use of a wheelchair • Autism • Muscular dystrophy • Intellectual disability (previously called mental retardation) Please Select one of the options: Yes, I have a disability (or previously had a disability) No, I dont have disability I dont wish to answer Name: Date: Format: MM/DD/YYYY Candidate Sign Off I certify that all information in this application is true and correct as of this date. eSignature: Are you human?
