The policy of the Virginia Peninsulas Public Service Authority is to collect, maintain, use and disseminate only the personal information required by law to accomplish a proper purpose.
Purpose, Use, Access, and Dissemination
Information furnished will be used primarily by VPPSA to determine qualifications for employment, eligibility for transfer, reinstatement, promotion, and/or demotion. All or part of this information may be furnished as indicated below:
1. Representatives from VPPSA, if required to determine employment suitability.
2. Federal, state, and local agencies in which you have an interest as a potential employee.
3. Federal, state, and local agencies to create personnel files following your employment withVPPSA.
4. Representatives of federal, state, and local agencies engaged in investigating violations of the law.
5. Individuals or agencies requesting statistical data exclusive or personal information.
6. Requesting agencies possessing your voluntary release of information and assuming confidential
protection of information released.
Effects of Nondisclosure
It is in your best interest to answer all questions on the Application for Employment. Your failure to complete the form may jeopardize your opportunity for employment. Completion of the EEO Applicant Information form which follows is voluntary, and cannot be used to jeopardize an opportunity for employment.
Disclosure of Social Security Number
The Social Security Act of 1976 provides for soliciting social security numbers, and disclosure on your part is mandatory to receive the benefits you are seeking.
Certification / Agreement
I have read and understand the above Privacy Act Notification for Employment Forms. I hereby certify that this application is a complete record and that all entries and all attachments are true and accurate to the best of my knowledge. I understand that false or incomplete statements herein supplied are grounds for disqualification from employment. I authorize VPPSA to conduct a thorough background investigation, except as it pertains to race, origin, sex, age, or other non-job-related criteria, to be used relative to my employment with VPPSA. I authorize my former employers and any other persons or organizations to provide any information they have about me and I release all concerned from any liabilities in connection therewith. If permanent employment is offered, I understand that I may be required to pass an examination given at VPPSA’s expense, and that my employment may be dependent
upon successfully passing that examination.