Application For Sodexo Job – Fill Out and Use This PDF

Sodexo provides equal employment opportunity without regard to race, color, religion, sex, pregnancy, national origin, ancestry, citizenship, age, marital status, disability, veteran status, sexual orientation, gender identity, genetic information, or any other basis protected by law. If needed, reasonable accommodations for the hiring process will be made.

CRIMINAL BACKGROUND CHECKS

Sodexo conducts comprehensive, pre-employment criminal background checks. Sodexo will not disqualify any candidate solely because he/she has a conviction. Sodexo will review criminal conviction information, if any, and will disqualify candidates if: (1) the nature of the conviction(s), the time elapsed since the conviction(s), and/or the relationship between the conviction(s) and the position, among other things, suggests that granting employment would pose a risk to Sodexo, its employees, clients, client employees, customers, and/or the general public; or (2) job-related client requirements prohibit Sodexo from placing a candidate at a particular client site due to his/her criminal conviction(s).

EMPLOYMENT EXPERIENCE

Please list your job history for the past six years or the last four employers (whichever covers a longer period of time). Start with your present employment and note any periods in which you were not employed. Include U.S. Military Service, summer/part- time jobs, and cooperative education assignments.

This information must be completed even if a resume is provided.

Reason for leaving:

May we contact your present employer to verify the above?

Yes, you may contact anytime.

Do not contact now. You may contact at a later date. _______________________________________________

(Please specify, for example: after acceptance of offer or a specific date, if appropriate.)

Have you ever been dismissed or forced to resign from employment? Yes No If yes, please explain:

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EDUCATION HISTORY

Academic Achievements or Activities: Please list academic honors, scholarships, or fellowships, memberships in academic honorary societies, or participation in extracurricular activities you consider significant.

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List current professional license(s), registration(s), and professional organizations or affiliates, if any.

(You must include license / registration numbers in specific states / jurisdictions where you are licensed or registered.)

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PROFESSIONAL OR PERSONAL REFERENCES

Do not contact now. You may contact at a later date. _____________________________________________________

(Please specify, for example: after acceptance of offer or a specific date, if appropriate.)

ACKNOWLEDGEMENT AND RELEASE

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING:

The information that I have provided is accurate to the best of my knowledge and subject to validation by Sodexo. I understand and agree that any misrepresentation or omission of fact in my application, in any supplement thereto, during any interview, or in any other employment-related records supplied or completed by me, shall be grounds for rejection of my application for employment or, if employed, for termination of my employment with Sodexo, regardless of the amount of time elapsed before discovery.

I understand that an offer of employment and my continued employment with Sodexo are contingent upon satisfactory proof of my authorization to work in the United States.

I understand that nothing contained in this employment application or in the granting of an interview or an offer of employment is intended to create a contract between myself and Sodexo for employment or for the providing of any benefit. No promises regarding continued employment have been made to me, and I understand that no such promise or guarantee is binding upon Sodexo unless made in writing and signed by me and an authorized representative of Sodexo. I understand that if I am employed by Sodexo, my employment will be terminable-at-will, and that either I or Sodexo may terminate my employment at any time, with or without cause, for any reason or no reason, and that I am not being employed for any specific term.

I understand that business needs at times may make the following conditions mandatory: overtime, shift work, and rotating schedules. I understand and accept these conditions of employment. I understand that Sodexo may require a pre-employment investigation of my criminal conviction history, educational background, past employment, and activities that may relate in any way to my potential fitness for employment. I further understand that I may be required to take and pass a drug and/or alcohol test either pre-hire or during the course of my employment. I agree to complete all required authorization forms and provide all information necessary for Sodexo, or its agent, to conduct any required investigation or drug/alcohol testing. If hired, I authorize Sodexo to conduct subsequent investigations and/or drug/alcohol testing during the course of my employment. In addition, I agree to comply with any background check and/or drug/alcohol testing requirements mandated by Sodexo’s client at my work location, as agreed to by Sodexo.

I authorize schools and prior employers to provide any information they have concerning me to Sodexo, and I hereby hold harmless Sodexo and all those providing information from any liability that may arise out of or result from the provision or use of such information.

Maryland Applicants: By signing below, you acknowledge receipt of the following notice:

UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.

Massachusetts Applicants: By signing below, you acknowledge receipt of the following notice:

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

WRITTEN DISCLOSURE FOR BACKGROUND INVESTIGATION

I understand that Sodexo, Inc. and/or its subsidiaries, will utilize the services of a consumer reporting agency (“CRA”), USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com), to obtain a consumer report and/or investigative consumer report as part of the procedure for processing my application for employment or other employment-related purposes, such as promotion, reassignment or retention. I understand that a consumer report may include information and/or records relating to my: criminal conviction history (consistent with federal and state law), civil court records, employment verification and references, education verification, social security number, professional license verification, past addresses, driving record, personal references, character, general reputation, personal characteristics or mode of living and may include an HHS OIG or OFAC exclusion check. I understand such information may be obtained through direct or indirect contact with former employers, schools, and public agencies or other persons who may have such knowledge. An “investigative consumer report” is a special type of consumer report in which the information described above is obtained through personal interviews with persons who may have relevant knowledge. I understand that my credit header information may be accessed; however, my full credit report will not be accessed unless I provide Sodexo an additional, separate authorization. This access will not affect my F.I.C.O. score.

I further understand Sodexo will utilize the services of USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com) or TalentWise Solutions LLC (“TalentWise”), 19800 North Creek Parkway, Suite 200, Bothell, Washington 98011 (877 893 1665), to obtain, through an authorized drug and alcohol testing facility, a consumer report consisting of a drug and alcohol test, when required for employment-related purposes.

I understand that any background investigation and/or drug and alcohol testing will be done in accordance with the Fair Credit Reporting Act (“FCRA”) and any applicable state law and acknowledge receipt of a copy of the document entitled “A Summary of Your Rights Under the Fair Credit Reporting Act”.

I understand that before Sodexo takes any adverse employment action based, in whole or part, on information obtained in the consumer report/investigative consumer report, I will be provided a copy of the report and a description in writing of my rights under the FCRA.

WRITTEN DISCLOSURE FOR BACKGROUND INVESTIGATION

STATE LAW NOTICES

For California applicants/employees only: Under California law, an “investigative consumer report” is a consumer report in which information on a consumer’s character, general reputation, personal characteristics, or mode of living is obtained through any lawful means. In connection with your application for employment and/or continued employment with Sodexo, Sodexo intends to procure an investigative consumer report. Sodexo, through its investigative consumer reporting agency (“ICRA”), may investigate the information contained in your employment application and other background information about you, including but not limited to obtaining a criminal record report, obtaining information about your character, general reputation, personal characteristics and mode of living, verifying references, work history, your social security number, your educational achievements, licensure, certifications, driving records, illegal drug use, and other information about you, including interviewing people who are knowledgeable about you. The results of this report may be used as a factor in making employment decisions. The source of any investigative consumer report will be USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com) or TalentWise Solutions LLC (“TalentWise”), 19800 North Creek Parkway, Suite 200, Bothell, Washington 98011 (877 893 1665) (for drug and alcohol testing only). Sodexo will provide you with a copy of an investigative consumer report when required to do so under California law.

Under California Civil Code section 1786.22, you are entitled to a visual inspection of files maintained on you by an ICRA, as follows: (1) In person, if you appear in person and furnish proper identification, during normal business hours and on reasonable notice. A copy of your file shall also be available to you for a fee not to exceed the actual costs of duplication services provided; (2) By certified mail, if you make a written request, with proper identification, for copies to be sent to a specified addressee.; (3) A summary of all information contained in your files and required to be provided by the California Code shall be provided to you by telephone, if you have made a written request, with proper identification for telephone disclosure, and the toll charges, if any, for the telephone call are prepaid by you or charged directly to you.

“Proper Identification” means information generally deemed sufficient to identify you, which includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity. The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection. You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person’s presence.

Massachusetts applicants/employees only: The precise nature and scope of any investigative consumer report (which commonly includes information regarding your character, general reputation, personal characteristics, and mode of living) will be the same types of information described above. You have a right to have a copy of any investigative consumer report upon request from USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com).

Minnesota applicants/employees only: You have the right to request a complete and accurate disclosure of the nature and scope of any consumer report from USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com) or TalentWise Solutions LLC (“TalentWise”), 19800 North Creek Parkway, Suite 200, Bothell, Washington 98011 (877 893 1665) (for drug and alcohol testing only).

Montana applicants/employee only: You have a right to request from Sodexo disclosure of the nature, scope, and substance of any investigative consumer report.

New Jersey applicants/employees only: The precise nature and scope of any investigative consumer report (which commonly includes information regarding your character, general reputation, personal characteristics, and mode of living) will be the same types of information described above. You have a right to have a copy of any investigative consumer report upon request from USA-FACT, Inc., 6200 Box Springs Blvd., Riverside, CA 95207 (800 547 0263 or www.usafact.com).

New York applicants/employees only: I acknowledge that I have received a copy of New York Correction Law Article 23-A.

ATTENTION NEW YORK APPLICANTS / EMPLOYEES

The following is a copy of the New York law relating to employment-related criminal background checks, which Sodexo is required to provide to you in accordance with New York General Business Law, Section 380-c, effective February 1, 2009.

NEWYORK CORRECTION LAW ARTICLE 23-A

AUTHORIZATION AND REQUIRED INFORMATION FOR

BACKGROUND INVESTIGATION

PLEASE PRINT LEGIBLY IN BLACK INK

3.EDUCATION VERIFICATION

(Please provide all requested information for college/university and post-secondary institutions only.)

Are you a Registered Dietitian? YES NO If yes, registration number: _____________________

In which states are you registered to practice dietetics? _____________________________________

4.PREVIOUS EMPLOYMENT VERIFICATION

(Please specify, for example: after acceptance of offer or specified date, if applicable.)