To work in this field, you must successfully pass a criminal history check (CHC); most positions also require a driving record check. This is the information required for those forms.
DMV
A driver’s license and current auto insurance is required to work for Renew Consulting. Please enter your driver’s license and insurance information here:
License# State Expiration Date (mm/dd/yyyy):
Auto Insurance Company: Auto Insurance Expiration Date (mm/dd/yyyy):
For the driving history below, your must list EVERY infraction and accident if you are age 25 or younger. If you have age 26 or older, you must list everything from the last three years. If you are unsure of your driving history,
leave this section blank and bring a copy of your Court Certified Driving Record (available from the DMV for $3.00) to the interview.
We DO run DMV checks, and if you do not complete this section accurately, you may be dropped from the program.
CHC
For the criminal history check below, your must list EVERY charge or arrest, even if it did not result in a conviction. If you do not want to provide your social security number, you must request a fingerprint card from us and have your
fingerprints taken at the Oregon State Police (this costs $20.00) and bring them to the interview. If you have lived outside the state of Oregon in the last five years, you have to have fingerprints taken anyway.
Social Security Number: --
Please send me a fingerprint card instead.
Have you had any founded reports of child abuse or substantiated abuse?
Check here if you have lived outside the state of Oregon for more than 60 days in the last five years.
Race: Sex:
Height: Feet Inches
Please list any other names you have used in the past, including your maiden name if applicable:
NOTE: If you have history that you believe has been "expunged" or removed from your record, or a crime for which you have been pardoned but you do not have documentation that it was removed, you should list it. A crime is not removed from your record until you complete the formal process to have it removed.
If you falsify or provide incomplete information, you may be denied.
List ALL arrests and charges that DID NOT result in a conviction, regardless of how long ago. If none, leave blank. Minor traffic violations such as parking tickets, speeding, or failing to stop at a stop sign or red light and NOT required to be listed (but should have been listed in the driving record above). DUII and DWS must be listed here. If you do not know the date, give an estimate.
List ALL convictions, including military convictions, regardless of how long ago. Include felonies, misdemeanors, probation violations and failures to appear. If none, leave blank.
If you have EVER been arrested, charged, or convicted, you must EXPLAIN the circumstances and what you have done to change your life since this history. Specifically:
Tell us what happened when you were arrested/convicted.
What did you have to do because of the arrest or conviction? Serve probation? Pay restitution?
List any treatment, counseling program, alcohol or drug rehabilitation, education, and training.
List employment demonstrating responsible behavior since then.
How is your criminal history relevant to your job or position (or working in this field)?
How has your life changed since the criminal history?
Why do you believe you are no longer a risk to vulnerable people?
Explain why you believe past behavior is not likely to recur (happen again).
I have a probation officer
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I certify that the facts and information provided in this training application packet are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of fact in this application or any other documents provided or required, as well as any misleading statements or omissions, may be cause of denial of services, training, and/or employment, or cause for immediate termination, regardless of how or when discovered.
I authorize the investigation of all matters which Renew Consulting, Inc. deems relevant to my qualifications for training and/or employment, including all statements in this application or accompanying resume, and employment history. I release from all liability any person, employer, or other named or unnamed informant supplying such information, and release Renew Consulting, Inc.. from all liability that may result from making the investigation. This includes any reference checks, driving record checks, criminal background checks, or drug screening whether before, during, or following employment.
I understand that my placement and/or employment is contingent upon, among other things, proof of my identity and employment eligibility pursuant to the Immigration Reform and Control Act of 1986, and passing a pre-placement or pre-employment drug screening test.
I understand and agree that if I am offered and accept a position or placement, I may be terminated, with or without cause, at any time. I understand that no employee or representative of Renew Consulting, Inc., other than the Owner/Executive Director or his or her authorized representative has any authority to enter into any employment agreement for any specified period of time or contrary to the terms stated in this application, and that any such agreement by the Owner/Executive Director or his or her authorized representative must be in writing to be valid. I also agree to conform to all existing and future Renew Consulting, Inc. rules and regulations and I understand that Renew Consulting, Inc. has the right to change wages, hours, and working conditions as deemed necessary.
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To meet our obligations to employees and clients, and to comply with our obligation under the Drug Free Workplace Act of 1988, the following policy has been adopted and will be enforced:
Renew Consulting, Inc., as well as any future employers, prohibits the unlawful use, sale, possession, manufacture, distribution, or being under the influence of alcohol, drugs or any controlled substance on property belonging to Renew Consulting, Inc. or future employers, while in the presence of clients, while on duty, during rest periods and break periods, during training, while attending a company sponsored event, or while operating a company vehicle.
Trainees or Employees who violate this prohibition will be subject to immediate termination of training, services, or employment by Renew Consulting, Inc., and may have employment immediately terminated by future employers. Nothing in this policy restricts Renew Consulting, Inc.’s right to terminate an employee at any time, with or without notice, for any reason not expressly prohibited by law.
Renew Consulting, Inc., requires that all trainees and/or employees report for drug and/or alcohol testing as part of the screening process prior to training or employment, and as a result of reasonable suspicion or following an accident in which there is injury to persons or damage to property.
Trainees and employees must abide by the terms of this statement and must notify the employer of any criminal drug conviction within five days of the conviction if workplace conduct is involved.
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I understand that the cost of classes is free to me. I understand that I will not be accepted into the training and placement program unless Renew Consulting, Inc. intends to match me with a job position. I understand if my work references are unacceptable, if I drop out of training, if I fail a drug screening, or if I lie on any part of my application or interview, then I will be dismissed from the program.
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I have read and understand the Drug Free Workplace Statement. I agree to comply with the Renew Consulting, Inc. Drug and Alcohol policy. I understand that any offer of training, services, and/or employment with this company is contingent upon the successful completion of drug testing before beginning work or training, and I consent to testing under Renew Consulting, Inc. policy. I understand and agree to all stipulations listed on this page and elsewhere in the application.
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