Personal Details

Exceed, LLC is committed to a policy of non-discrimination in all aspects of its human resources management and administration. Selection, compensation, and progression are based on qualifications and job-related factors without regard to race, color, age, sex, religion, national origin, citizenship status, ancestry, disability, military status, or unfavorable discharge from military service or any other characteristic protected by law. Exceed will provide accommodations to anyone needing assistance in completing the application process.

Federal immigration law requires that all individuals accepted for employment provide proof of citizenship or authorization to work in the United States.

Personal Information

Authorization to Work

Security

Professional Awards and Associations

Employment


Education

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College/ University
Name/Location
Degree Awarded? (Specify Type) *
Major Field of Study

Professional References

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Name
Title
Present Organization
Business Phone
Home Phone

Exceed, LLC reserves the right to terminate all employment relationships at any time, without notice, for any reason.

Consent To Drug Testing

In compliance with the Drug-Free Workplace Act of 1988, Exceed, LLC has a longstanding commitment to providing a safe, quality-oriented and productive work environment consistent with the standards of the community in which we operate. Alcohol and drug abuse pose a threat to the health and safety of Exceed, LLC employees, and to the security of our equipment and facilities and to those of our customers. For these reasons, Exceed, LLC is committed to the elimination of drug and/or alcohol use and abuse in the workplace.

For the purpose of being further considered for employment, I hereby agree to submit to a drug and/or alcohol test.

I do hereby agree to submit to testing to be performed by an Exceed authorized Occupational Health/Urgent Care Center for detection of drugs and/or alcohol. I understand that I will be tested for use of commonly-abused controlled substances, including, but not limited to: Amphetamines, Barbiturates, Benzodiazepines, Opiates, Cannabinoids (Marijuana), Cocaine, Methadone, Methaqualone, Phencyclidine (PCP), Propoxyphene, and chemical derivatives of these substances.

If I am accepted for employment, I agree to take drug and/or alcohol tests whenever requested by Exceed, LLC, and I understand that the taking of such tests is a condition of my continued employment.

Veteran Status

Exceed, LLC 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 disabled veterans, recently separated veterans, active duty wartime or campaign badge veterans and 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 veteran's 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 Labor's 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 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. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information provided will be used only in ways that are consistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended.


Voluntary Self-Identification

Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do you know if you 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, of if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to:

  • Missing limbs or partially missing limbs

  • Nervous system condition for example, migraine headaches, Parkinson’s disease, or Multiple sclerosis (MS)

  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression

  • Alcohol or other substance use disorder (not currently using drugs illegally)

  • Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders

  • Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities

  • Partial or complete paralysis (any cause)

  • Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD

  • Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema

  • Missing limbs or partially missing limbs

  • Short stature (dwarfism)

  • Traumatic brain injury

  • Intellectual disability

  • Autism

  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS

  • Blind or low vision

  • Cancer

  • Cardiovascular or heart disease

  • Celiac disease

  • Cerebral palsy

  • Deaf or hard of hearing

  • Depression or anxiety

  • Diabetes

  • Epilepsy

  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome

Please check one of the boxes below:

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