Application For Employment

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Application For Employment

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We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis, including race, color, age, sex, religion, or national origin. We participate in E-Verify.

PERSONAL INFORMATION

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DATE: *

NAME (Last, First, Middle): *

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ID *

ID
DL
CDL
NONE

VALID TN ID NUMBER: *

PRESENT ADDRESS: *

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CITY: *

STATE: *

ZIP: *

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PHONE NUMBER: *

EMAIL: *

IN CASE OF EMERGENCY, CONTACT: *

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PRESENT ADDRESS: *

CITY: *

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STATE: *

ZIP: *

PHONE NUMBER: *

EDUCATION HISTORY:

(LIST HIGH SCHOOL, COLLEGE, VOCATIONAL AND TRADES)

List 1

NAME/LOCATION

COMPLETED (Y/N/NA)

AREA(S) OF STUDY

List 2

NAME/LOCATION 2

COMPLETED (Y/N/NA) 2

AREA(S) OF STUDY 2

List 3

NAME/LOCATION 3

COMPLETED (Y/N/NA) 3

AREA(S) OF STUDY 3

List 4

NAME/LOCATION 4

COMPLETED (Y/N/NA) 4

AREA(S) OF STUDY 4

List 5

NAME/LOCATION 5

COMPLETED (Y/N/NA) 5

AREA(S) OF STUDY 5

WORK EXPERIENCE:

(LIST LAST THREE EMPLOYERS)

FROM

POSITION

PAY

COMPANY & ADDRESS

REASON FOR LEAVING

FROM

POSITION

PAY

COMPANY & ADDRESS

REASON FOR LEAVING

FROM

POSITION

PAY

COMPANY & ADDRESS

REASON FOR LEAVING

DESIRED EMPLOYMENT

POSITION: *

START DATE: *

DESIRED PAY: *

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PREFERRED SHIFTS: *

8-HR
10-HR
12-HR
ANY
OTHER

QUESTIONNAIRE

If necessary, are you willing and able to perform the following with or without a reasonable accommodation:

Use/wear all required safety equipment? *

Use standard construction hand tools? *

Operate power tools/equipment safely? *

Lift items weighing up to 75 pounds? *

Use a jackhammer up to 90 pounds? *

Work on bridges over water? *

Work on bridges over land? *

Work heights over 50 feet? *

Work heights over 100 feet? *

Work underneath structures in close spaces? *

Crawl from one area to another to gain access? *

Walk through areas that may contain holes or narrow walkways? *

Work a changing schedule? *

Travel to work in other areas? *

Work weekends? *

Work night shifts? *

Are you legally eligible to work in the United States? *

I HEREBY CERTIFY THAT ALL INFORMATION ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY MISREPRESENTATION OR OMMISSION OF FACTS WILL RESULT IN THE TERMINATION OF MY EMPLOYMENT. I AUTHORIZE INVESTIGATIONS OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. FURTHER, I UNDERSTAND AND AGREE THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PREVIOUS NOTICE.

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Date *

Signature *

VOLUNTARY SELF-IDENTIFICATION FORM

We are an equal opportunity employer and consider all applicants for positions without regards to race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, or any other classification protected by applicable federal, state or local laws.

In order to comply with certain government recordkeeping and reporting requirements for the administration of civil rights laws and regulations, we invite you to voluntarily complete this form. Submission of this information is strictly voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual. Thank you for your cooperation.

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NAME: *

POSITION APPLIED FOR: *

GENDER: *

MALE
FEMALE

EEO SELF-IDENTIFICATION

Is your ethnicity Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race) *

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Please check one or more boxes below regarding your race, if applicatble. *

White – A person having origins in any of the original peoples of Europe, the Middle East or North Africa.
Black or African American – A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Pacific Islander – A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.
Asian – A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
Native American or Alaska Native – A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
I do not wish to disclose.

Application For Employment