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I affirm that the information submitted in my application for employment is true and correct, and that there are no omissions. I understand that any false information, omission or misrepresentations of the facts called for on this form may result in rejection of my application or discharge at any time during my employment

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At HealthFitness we do not discriminate in hiring or employment on the basis of race, religion, color, sex, age, national origin, disability, veteran status, genetic information, or any other characteristic protected by law. HealthFitness provides reasonable accommodations to applicants and employees with disabilities and takes affirmative action to ensure that hiring and employment decisions are made without regard to protected class status. If you need a reasonable accommodation as part of the application process, please contact our Recruiting Department at 1-800-636-3304.

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Health Fitness Professional (substitute)

Naperville, IL
 • 
ID: 20210813

Application Form






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Voluntary Self-Identification of Disability

Form CC-305
OMB Control Number 1250-0005
Expires 05/31/2023

Why are you being asked to complete this form?

We are a federal contractor or subcontractor required by law to provide equal employment opportunity to qualified people with disabilities. We are also required to measure our progress toward having at least 7% of our workforce be individuals with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had a disability. Because a person may become disabled at any time, we ask all of our employees to update their information at least every five years.

Identifying yourself as an individual with a disability is voluntary, and we hope that you will choose to do so. Your answer will be maintained confidentially and not be seen by selecting officials or anyone else involved in making personnel decisions. Completing the form will not negatively impact you in any way, regardless of whether you have self-identified in the past. For more information about this form or the equal employment obligations of federal contractors under Section 503 of the Rehabilitation Act, visit the U.S. Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.Disabilities include, but are not limited to:

  • Autism
  • Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, or HIV/AIDS
  • Blind or low vision
  • Cancer
  • Cardiovascular or heart disease
  • Celiac disease
  • Cerebral palsy
  • Deaf or hard of hearing
  • Depression or anxiety
  • Diabetes
  • Epilepsy
  • Gastrointestinal disorders, for example, Crohn's Disease, or irritable bowel syndrome
  • Intellectual disability
  • Missing limbs or partially missing limbs
  • Nervous system condition for example, migraine headaches, Parkinson's disease, or Multiple sclerosis (MS)
  • Psychiatric condition, for example, bipolar disorder, schizophrenia, PTSD, or major depression
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PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Pre-Offer Invitation to Self-Identify as a Protected Veteran

This employer is a Government contractor or subcontractor subject to the Vietnam Era Veterans' Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAA), which requires Government contractors to take affirmative action to employ and advance in employment "protected veterans": (1) disabled veterans; (2) recently separated veterans; (3) active duty wartime or campaign badge veterans; and (4) Armed Forces service medal veterans.  See Descriptions

This employer is subject to certain governmental recordkeeping and reporting requirements under VEVRAA. In order to comply with these requirements, we invite you to check the appropriate box below. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information you provide will be kept confidential and will only be used in ways that are consistent with VEVRAA.

This employer is committed to the goal of equal opportunity in employment. To further this goal, this employer maintains an affirmative action program that includes policies and practices to assure non-discrimination and affirmative action for protected veterans.

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