Employment Application

1 Personal Information
2 employment information
3 Education & training
4 Experience
5 Employment history
6 sign & submit

Personal Information

Full Name
Address / Street or Box
City
State
Zip
Email
Cell Phone
Home Phone
If necessary, when is the best time to call you at home?
Driver's License #
Driver's License State
Driver's License Expiration
Are you presently employed?
Can we contact you at work?
If Yes, Work Number
Best Time To Call
Are you legally eligible for employment in this country?Proof of U.S. citizenship or immigration status will be required.
Have you ever been employed here before?
If Yes, From
To
Supervisor
Reason for Leaving

Employment Information

Position Desired
Date Available
Are you willing to work overtime?
Are you on a lay-off and subject to recall?
Are you a veteran?
Are you a Vietnam Veteran?
Are you willing to work away from home?
Will you undergo a pre-employment drug test?
Have you been convicted of a felony in the last seven (7) years?
If Yes, Please ExplainSuch conviction may be relevant if job-related, but does not bar you from employment.
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Education & Training

High School

School Name
Location
Did you graduate?
Major Subject & Hours Completed
Minor Subject & Hours Completed
Total Hours

College

School Name
Location
Did you graduate?
Major Subject & Hours Completed
Minor Subject & Hours Completed
Total Hours

Trade or Technical School

School Name
Location
Did you graduate?
Major Subject & Hours Completed
Minor Subject & Hours Completed
Total Hours

Skills

List the skills that you are cross-trained in or additional special skills you may have relating to construction work that you can perform.
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Experience

Farm Tractor
Models
Rough / Finish or Type of Work
Years Experience
For Whom
Roller
Models
Rough / Finish or Type of Work
Years Experience
For Whom
Dozer
Models
Rough / Finish or Type of Work
Years Experience
For Whom
Motor Grader
Models
Rough / Finish or Type of Work
Years Experience
For Whom
Scraper
Model
Rough / Finish or Type of Work
Years Experience
For Whom
Loader
Model
Rough / Finish or Type of Work
Years Experience
For Whom
Excavator
Model
Rough / Finish or Type of Work
Years Experience
For Whom
Welder
Model
Rough / Finish or Type of Work
Years Experience
For Whom
Service Man
Model
Rough / Finish or Type of Work
Years Experience
For Whom
Truck Driver
Model
Rough / Finish or Type of Work
Years Experience
For Whom

Employment History

Employment 1

Employer Name
Supervisor's Name
Address
Phone
Position Held
From
To
Reason for Leaving
Account for Period Between JobsInclude dates and reason.

Employment 2

Supervisor's Name
Employer Name
Address
Phone
Position Held
From
To
Reason for Leaving
Account for Period Between JobsInclude dates and reason.

Employment 3

Supervisor's Name
Employer Name
Address
Phone
Position Held
From
To
Reason for Leaving

Relevant Training & Experience

Please list any experience or training relevant to the position you are applying for:Example: Types of equipment operated or maintenance performed on.
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Applicant Must Read and Sign

I certify that I have read and understood all of this employment application. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not, and I release employers and other persons named herin from all liability for any damages on account of furnishing such information. I understand that as an applicant for a position with this company I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical and drug test. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.

It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508; I have been told that this investigation may include an investigative Consumer Report, including information regarding my character, general reputation, person characteristics, and mode of living.

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file. I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer.

By submitting this application, including electronically, this certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Signature
Date
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