Employment

Position for which you are applying:

How did you learn of this job opening? (Radio, Internet, VEC, Employee, Other):

Have you ever filed an application with us?:

Personal Information

Name:

Email:

Phone:

Address:

City, State, Zip:

Are you currently employed?
YesNo
If no, how long have you been unemployed?:

Have you ever been convicted of a felony?:
YesNo
If yes, please explain:

If hired, can you provide proof of eligibility to work in the United States?:
YesNo
If hired, when could you begin work?:

Personal transportation to and from work is a required element of this job.
Can you meet this requirement?
YesNo
Consistently staying out of town up to 2 weeks is a requirement for this job.
Is there any reason this will be a problem?
YesNo
Some evening work may occasionally be required for this position.
Can you meet this requirement?
YesNo
Some weekend work may occasionally be required for this position.
Can you meet this requirement?
YesNo
Are you willing to relocate?:
YesNo

College

Years of college courses complete
(1-4, Graduate program)

Name and location of school(s):

Major(s):

Did you graduate?
YesNo

Trade/Business/Correspondence School

Name and location of school(s):

Course of study:

Did you graduate?:

Special studies/skills applicable to construction (list all hands on, mechanical, and electrical experience.)

Military

Have you served in the U.S. Military:
YesNo
If yes, how many years?:

Final rank:

Are you a present member of the National Guard or Reserves?:
YesNo
Are you 18 years or older?:
YesNo

*The U.S. Department of Transportation requires that driver applicants state their date (mo/day/yr) of birth (§391.21 (b)(2)). The Age Discrimination Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.
Do you currently have a valid driver's license?: YesNo

Operator's License

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?:
YesNo
Has any license, permit, or privilege ever been suspended or revoked?:
YesNo
Have you ever been disqualified for violations of the Federal Motor Carrier Safety Regulations?:
YesNo

Do you have any offenses that are not reflected on your DMV record? If yes, list details:

Accident Review (Past 3 Years)

Previous Employers

List all employers in the last 10 years, starting with the most recent.
Employer 1
Employer:
Supervisor:
Address:
Phone:
Position held:
Start Date:
End Date:
Specific work performed:
Beginning pay:
Ending pay:
What did you like best about this job?
What did you like least about this job?
Reason for leaving:

Employer 2
Employer:
Supervisor:
Address:
Phone:
Position held:
Start Date:
End Date:
Specific work performed:
Beginning pay:
Ending pay:
What did you like best about this job?
What did you like least about this job?
Reason for leaving:

Employer 3
Employer:
Supervisor:
Address:
Phone:
Position held:
Start Date:
End Date:
Specific work performed:
Beginning pay:
Ending pay:
What did you like best about this job?
What did you like least about this job?
Reason for leaving:

Employer 4
Employer:
Supervisor:
Address:
Phone:
Position held:
Start Date:
End Date:
Specific work performed:
Beginning pay:
Ending pay:
What did you like best about this job?
What did you like least about this job?
Reason for leaving:

References

May we contact your current supervisor as a reference?
YesNo
If yes, please include his/her contact information:
Name:
Daytime phone:
Address:
Business:
*At least two references should be people not related to you for whom you have worked. One of which must be a military reference if discharged within the past 7 years.
Reference 1
Name:
Address:
Phone:
Business:
Relationship:

Reference 2
Name:
Address:
Phone:
Business:
Relationship:

Reference 3
Name:
Address:
Phone:
Business:
Relationship:

I understand that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, I will be required to pass a physical examination and a drug/alcohol screen as a condition of employment. I also understand and agree that I may periodically be required to submit to and pass random drug/alcohol screens as a condition of employment. I may also be required to submit to and pass drug/alcohol screens if I exhibit behavior that may, by a reasonable person, be perceived to be indicative of drug and or alcohol abuse.

Nothing on the application is intended to create or imply a contractual relationship; if hired, I understand that employment is at will, i.e., is not for any time period or duration, and can be terminated with or without reason at any time.
Please check the following box to agree to the above: