Nitro Construction Services wants to take reasonable precautions in hiring and employment decisions to protect employees, customers, and clients from harm, including the development of a reasonable process for identifying when an employee or prospective employee has a criminal record that may pose a credible risk. There is a delicate line between providing a safe workplace and refraining from considering an employee’s criminal history except as it relates to suitability for employment. As best we can, we want to strike an appropriate balance between these considerations and exercise proper due diligence with all prospective and current employees.
Have you ever been convicted of a felony or plead guilty or no contest to a felony charge? If so, please disclose details below (A background check will be required if this section is completed): NCS Form 054
The President and Corporate Safety Director at Nitro Construction Services will determine whether further action is necessary. We will review the preliminary information provided, the completed background check and assess where the employee may be working. We will pay special attention to the amount and type of exposure to others. There may be circumstances where the employee or prospective employee is not suitable for employment. All decisions made in this regard shall be made without any consideration of race, national origin, ancestry, age, gender, or physical attributes. Failure to disclose all information required by this form shall be grounds for immediate termination of employment.
Employee Name: (print) __________________________________________________________________________
Employee Signature: ___________________________________________________________________________
Employee Full Social Security Number: _________________________
Today’s Date: ___________________________