Education
High School
Name and Address
Did You Graduate
Yes
No
Course of Study or Degree Conferred
College
Name and Address
Did You Graduate
Yes
No
Course of Study or Degree Conferred
Other
Name and Address
Did You Graduate
Yes
No
Course of Study or Degree Conferred
Are you presently attending school or do you plan on furthering your education?
Yes
No
If so, please specify courses being taken and time commitment:
What experiences, skills, or qualifications do you feel especially would qualify you for work with our organization?
Have you ever been convicted of a crime, excluding minor traffic offenses?
Yes
No
(A yes response does not automatically disqualify a job applicant from further consideration.)
If yes, describe in detail:
Are there any felony charges pending against you currently?
Yes
No
If yes, please describe:
Do you hold any professional licenses or certifications?
Yes
No
If yes, please describe:
Have you ever had a professional license or certification revoked or suspended?
Yes
No
If yes, please describe:
Are you currently under investigation by any agency or department concerning any licensure or certification matter?
Yes
No
If yes, please describe:
Are there any medical reasons now or in the past that would restrict you from performing the physical demands of a construction job?
Yes
No
If yes, please describe:
Authorization and Understanding
I represent that the answers and information given by me in this application are true and complete. I understand that any incomplete, misleading or false statements in this application or in an interview can result in immediate disqualification or termination, if hired.
I authorize the Company to verify the information I have provided and to make an investigation of my background deemed necessary, both at the time of application and later during my employment, if I am hired. I understand that the types of investigations which the Company may perform include reference checks including personal, employment and educational reference checks, and so forth. I understand that I may have to provide further information to assist in these investigations, including my social security number, and I may be fingerprinted. I also authorize third parties (such as former employers, financial institutions, educational institutions) contacted by the Company to furnish any information relevant to my application for employment except health and/or disability information and I further release all persons and organizations from any and all liability for any and all damages whatsoever for releasing such information as authorized. I also waive all written notice from all prior employers related to providing such information.
I have no objection to signing an employee agreement on confidential information. I consent to all medical examinations and drug and alcohol testing which may be required, both during the selection process and throughout employment, if I am later hired.
I understand and agree that if I am hired, employment is "at will" and that either I or the Company can terminate my employment and compensation, with or without cause, and with or the Company can terminate my employment and compensation, with or without cause, and with or without notice, at any time. I acknowledge that no representations, either oral or written, have been made to me to the contrary and that any pre-existing understandings which contradict an "at will" status of employment are canceled. Further, I understand that only the Company President has any authority to enter in to any agreement for employment for any fixed period of time, or to make any agreement contrary to the foregoing and that any such agreement must be in writing and signed by the President and me.
In consideration of my employment, I agree to conform to the rules and policies of the Company. Also, I agree not to begin any action or lawsuit relating directly or indirectly to employment with the Company more than six (6) months after the earlier of (a) the incident or event giving rise to such action or lawsuit or (b) the date of the termination of such employment. I waive any statue of limitations to the contrary. However, I agree that any shorter statute of limitations remain in effect.
This application for employment shall be considered active for sixty (60) days. If I wish to be considered for employment after that time period, I understand that I must inquire at that time whether or not applications are being accepted.
Typing my name below indicates that I have read and understood the above paragraphs.
Name:*
Date:*
