Program Application This application helps BSNY place candidates with leading developers and contractors in the affordable housing space. Basic InformationName* First Last Phone*Gender*MaleFemaleDate of Birth* Email* Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you a NYCHA resident?*YesNoIf you are a NYCHA resident, please provide your NYCHA development name. Example: RooseveltHow did you hear about us?*Referring Agency or Other OrganizationFamily/FriendCommunity Flyer/PosterFacebookTwitterInstagramIndeed.comBSNY WebsiteOtherIf an agency or organization sent you, please provide the organization name and/or person's nameCommunity Board #Emergency ContactName First Last PhoneRelationshipEducation and Demographic InformationWhat is the highest level of education that you have completed*Less Than High SchoolSome High SchoolHigh School DiplomaHigh School Equivalency (GED/TASC)Vocational SchoolSome collegeAssociate's DegreeBachelor's DegreePost-Graduate (Master's or PhD)Licenses and Certifications (only check those that are currently valid)* None OSHA (10 hour) OSHA (30 hour) F-60 Fire Guard S-60 Fire Guard Flagger NYCDOB Scaffolding (4 hour) NYCDOB Scaffolding (16 hour) NYCDOB Scaffolding (32 hour) Concrete Finishing / Masonry C.P.R. / First Aid Security Guard Rigger/Signal Person Certification Mobile Crane Operator Tower Crane Operator Welding G-60 Torch Use Other Are you a Veteran?*YesNoWhat is your current employment status?*EmployedEmployed, but received notice of termination/layoff (including military separation)UnemployedOther Demographic InformationEthnicityNon Hispanic/ Latino-LatinaHispanic/Latino-LatinaRaceWhiteBlack or African AmericanAsianAmerican Indian or Alaskan NativeNative Hawaiian or Pacific IslanderPositions of InterestPlease choose which positions or trades you would like to be considered for* General Laborer HVAC Drywall Scaffolding Carpentry Roofing Painting Plumbing Masonry Flooring/Tile Electrical Porter Work CriteriaWorkers need to be able to be on the job site at 7 AM, ready to work, every day, regardless of weather. An aptitude and strong interest in construction work, which is outdoors; will require lifting and physical labor 8 hours a day; Ability to follow directions/supervision., and have strong work ethic. The above are criteria which must be met prior to enrolling into Building Skills.Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?*YesNoAre you able to pass a drug test if provided today?*YesNoPlease indicate what work gear you currently own Hard hat Construction boots Gloves Safety vest Do you speak any other language other than English?*YesNoIf so, what other language(s) do you speak?Employment History and ExperienceTrade Work Experience (please choose all that apply)* General Laborer HVAC Drywall Scaffolding Carpentry Roofing Painting Plumbing Masonry Flooring/Tile Electrical None Most Recent Job Title/ OccupationAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Start Date End Date Hours Worked Per WeekPhoneReason for Leaving*Current PositionResignedSeasonalTerminatedTemporaryJob DutiesApplicant StatementRead Carefully: I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law. I understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States of America and that federal immigration laws require me to complete an I-9 Form in this regard. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) eliminate me from further consideration for employment, or (2) may result in my immediate discharge from the employer’s service, whenever it is discovered. I have fully understand and accept all terms of the foregoing Applicant Statement*YesNoApplicant's Name (DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT)* First Last Today's Date Upload resume here if availableAccepted file types: jpg, pdf, doc, docx.Upload OSHA10 here if available (photo or scanned copy)Accepted file types: jpg, pdf, doc, docx.Upload other certifications here if available (photo or scanned copy)Accepted file types: jpg, pdf, doc, docx.