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Apply to ReHire Contract - IN Payroll

Please enter email provided on original application.
Please review your attached contract or hiring letter of intent.
Emergency Contacts
In case of emergency, please use the following as my primary contact. Please list name.
Please list Primary Contact's Phone Number.
Please list your relationship to Primary Contact.
In case of emergency, please use the following as my secondary contact. Please list name.
Please list Secondary Contact's Phone Number.
Please list your relationship to Primary Contact.
Policies
The following are CFAIA Policies.
Sexual Harassment Policy
• Unwelcome sexual advances • Requests for sexual acts or favors • Insulting or degrading sexual remarks or conduct directed against another employee • Threats, demands or suggestions that an employee’s work is contingent upon toleration or acquiescence to sexual advances • Retaliation against employees for complaining about such behaviors • Any other unwelcome statements or actions based on sex that are sufficiently severe or pervasive so as to unreasonably interfere with an individual’s work performance or create an intimidating, hostile or offensive work environment
Prohibited Discriminatory Policy
its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual's income is derived from any public assistance program or protected genetic information in employment or in any program or activity conducted or funded by the CFAIA. (Not all prohibited bases will apply to all programs and/or employment activities.)
JEDI Policy Acceptance
JEDI Policy Attached. Please review.
FIND Outdoors (FIND) believes that all people have the right to explore, discover and enjoy the public lands that we manage in a safe, comfortable and accessible manner. FIND staff aims to ensure all visitors always feel welcomed and invited to be a part *
Justice: Dismantling barriers to resources and opportunities in society so that all individuals & communities can live a full & dignified life. These barriers are essentially the “isms” in society: racism, classism, sexism, etc. Equity: Allocating resources to ensure everyone has access to the same resources & opportunities. Equity recognizes that advantages and barriers—the ‘isms’—exist. Equity is the approach & equality is the outcome. Diversity: The differences between us based on which we experience systemic advantages or encounter systemic barriers to opportunities. Inclusion: Fostering a sense of belonging by centering, valuing, and amplifying the voices, perspectives and styles of those who experience more barriers based on their identities.
Pet Liability Release Form
CFAIA employees, including campground and recreation area hosts, may be accompanied by a pet only when fulfilling those duties that allow the employee to provide full-time, hands-on restraint by an appropriate restraint system (e.g. leash, harness, etc.). With prior written approval by a CFAIA Director, Supervisor, or Manager, pets with special needs may be safely maintained in a pen or crate in a work environment on a case by case basis.
Will you be bringing a pet? *
I warrant and represent that any pet is current on required shots and immunizations, and I agree to abide by recreation area/campground pet rules and local leash laws. I assume and bear all the risk of loss, injury and damage of any kind to my pet while at or on the recreation area or campground property, whether caused through my negligence, the actions of other guests or employees, or the actions of other pets or wild animals, and shall hold the CFAIA harmless for any such claims. I assume and shall bear all risk of loss, injury and damage of any kind or nature to any employee or property of the CFAIA and other recreation area/campground guests caused by my pet, and I agree to indemnify and defend the CFAIA and hold it harmless for any such claims.
Family/Guest Release Form
If you have Family/Guests staying with you, then: *
I understand and acknowledge that I am fully aware of and assume the risks, including but not limited to the risk of serious bodily injury, property loss or damage to family members or guests staying at my site during my contract term with the CFAIA, including days on site during pre-orientation, training, and post-contract transition. I understand that the CFAIA shall have no responsibility to pay for medical treatment and related costs if a family member or guest is injured. I understand that my family members and guests are expected to abide by CFAIA policies at all times.
Acceptance of Attached Documents
This was attached to your email.
This was attached to the email. Please review and let us know you received it.
Post Offer Medical Questionnaire
I herewith affirm that the employer has made me an offer of employment, conditioned on the satisfactory completion of this questionnaire. The purpose of this inquiry is: to determine whether I currently have the physical qualifications necessary to perform the job that has been offered; to determine whether and what accommodations may be necessary; and to determine whether I can perform the essential functions of the job, without posing a significant direct threat to the health and safety of myself and others. This information will be kept strictly confidential. I hereby affirm that the questions in the medical questionnaire have not been asked of me by anyone with the employer until after I have signed this statement and been offered a conditional job.
Attached is the Medical Questionnaire you completed in the past. Please review carefully and list any changes to your medial condition.
Please advise your manager of any work restrictions as soon as you become aware of this need.
The information on this form shall not be used to discriminate against a qualified individual with a disability in regard to the following: job application procedures; hiring, advancement or discharge of the employee.
Under penalty of perjury, I declare that I have read the foregoing and that the facts alleged are true to the best of my knowledge and belief.
IN Payroll Information
W-4
Please enter total number of allowances you are claiming.
Employee's Signature *
I have reviewed the W-4 attached and I certify that under penalties of perjury, that I have completed this tax information to the best of my ability.
State Withholding
WH-4 Indiana
Indiana Employee's Withholding Exemption and County Status Certificate: Please review and answer the following questions regarding completion of Form WH-4.
Please enter total number of allowances you are claiming.
You are allowed one (1) exemption for each dependent. Enter number claimed.
Please choose the Indiana County of Residence as of January 1; If you do not live in the state of Indiana but work there, then choose the Indiana County of Principal Employment. (Hardin Ridge is in Monroe County, Indian Celina is in Perry County and Tipsaw is in Spencer County)
Please indicate if you are a resident or non-resident in the state of Indiana
I certify, under penalties provided by law, that I have completed the tax information to the best of my ability.
Employee Direct Deposit Enrollment Form
Direct Deposit *
Please enter Your Bank Name
Direct Deposit Type
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