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The Segal Company considers all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, disability, marital status, status as a disabled veteran or veteran of the Vietnam era, special disabled, or other veteran who served in a war, or in a campaign, or expedition for which a campaign badge has been authorized. The Company also complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains offices. In addition, the Company provides reasonable accommodations for qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local laws.

Please fill out this form as completely as possible. Attach current resume if available.

Section One

Section Two: Education

Include professional licenses, certifications, and/or accreditation and dates of attainment. For example, Society of Actuaries ASA/FSA designations, CEBS, SHRM, CPA, etc.
Include honor societies, honors received and offices held, etc. Exclude organizations that would reveal race, religion, creed, color, national origin, sex, age, disability, marital status, sexual orientation, or citizenship status or any other information that would indicate your status in any group or class protected by federal, state, or local law.
If so, give titles, publications, and dates.

Section Three: Business Experience

Begin with your most recent position. All time must be accounted for including time UNEMPLOYED since conclusion of schooling. If additional space is required, use Section 5 of this application or add an addendum page to this application. NOTE: This section must be completed. Substituting a resume is not permitted.

month/year
month/year

Section Four: Business References

Please include information for four business references (can not be relative).

Section Five: Additional Information

Word (.doc) or Portable Document File (.pdf). Max 300 KB

Please read carefully before submitting

I understand and agree that:

  1. The information that I have provided on this application and on my resume is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of employment, or if employed, termination from The Segal Company's employ.
  2. Any offer of employment I may receive from The Segal Company is contingent upon my successful completion of the Company's total pre-employment screening process, including the Company's receiving a satisfactory background investigation, references it considers satisfactory, and my satisfactory completion of any post-offer pre-employment medical examination that the Company may require. I also agree, if employed, to submit to a medical examination at any time at the Company's request, consistent with applicable law. I hereby consent to having the results of any medical examinations I may be required to take disclosed to The Segal Company or its designated representatives.
  3. I understand that as a condition of employment, I may also be required to undergo and successfully pass a screening for drugs. I also understand and agree that, if employed, I may be required to submit to an alcohol and/or drug screening at any time at the discretion of The Segal Company consistent with applicable laws. I hereby consent to having the results of any such screenings disclosed to The Segal Company or its designated representatives.
  4. I authorize and request that all of my present and former employers and those individuals I have listed as references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them from any and all liability for damages arising from furnishing the requested information.
  5. In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of the Company, which may be amended from time to time, and understand that my employment will be considered to be "at will," which means that my employment and compensation can be terminated with or without cause or notice at any time, at the option of either The Segal Company or myself (unless I am covered by the provisions of a collective bargaining agreement, in which case I understand the provisions of such agreement with respect to my employment status will govern my employment). I further understand that no manager or representative of The Segal Company, other than the President and CEO, General Counsel, or Senior Vice President and Chief People Officer, has any authority to make or enter into any agreement with me guaranteeing employment for any specified period of time. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and the President and CEO, General Counsel, or Senior Vice President and Chief People Officer.
  6. In accepting employment with The Segal Company, I acknowledge that I am not currently bound by any other agreement, with any other employer, entity, or individual which interferes with my ability to accept employment with Segal or restricts in any way my ability to work for Segal or perform the duties and responsibilities of the position for which I am applying. I also agree that if I am bound by any such agreement, I will provide a copy of the agreement to Segal's General Counsel and Senior Vice President and Chief People Officer before accepting an offer of employment.