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Step 1 of 8 - General Information

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  • Employment Record

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  • Voluntary Self-Identification

    RGC Resources is subject to Executive Order 11246, as amended, which requires federal government contractors to ensure that applicants are employed and that employees are treated during employment without regard to their race, color, religion, sex, or national origin. We are therefore requesting information about the race or ethnicity and sex of our applicants in order to comply with government reporting requirements and in order to ensure equal employment opportunity.

    COMPLETION OF THIS FORM IS STRICTLY VOLUNTARY

    The information provided will only be used in ways that are not inconsistent with Executive Order 11246, as amended, or other applicable laws and regulations. This information will be maintained separately from your application for employment.
  • Voluntary Self-Identification Continued

    RGC Resources is a Federal 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”). As a Federal contractor, we are required to take affirmative action to employ and advance in employment disabled veterans, recently separated veterans, Armed Forces service medal veterans and Active duty wartime or campaign badge veterans.

    Definitions:

    Disabled Veteran means (i) 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 (ii) a person who was discharged or released from active duty because of a service-connected disability.


    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.

    Recently Separated Veteran means a veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval or air service.

    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 (61 Fed. Reg. 1209).

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

    Disclosure of your status as a covered veteran is voluntary. Choosing not to provide this information will not subject you to any adverse treatment.
  • Voluntary Self-Identification Continued

    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.

    If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

    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
    Deafness
    Cancer
    Diabetes
    Epilepsy
    Autism
    Cerebral Palsy
    HIV/AIDS
    Impairments requiring use of a wheelchair
    Schizophrenia
    Muscular Dystrophy
    Major Depression
    Multiple sclerosis (MS)
    Missing limbs or partially missing limbs
    Post-traumatic stress disorder
    Obsessive compulsive disorder
    Intellectual Disability (previously called mental retardation)
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  • Reasonable Accomodation Notice

    Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

    If an offer of employment is made and, because of a physical or mental disability, you will need accommodation to perform any essential job function, please make the fact known to the individual processing your application.

    i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

    PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.

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