Please fill in all requested information since we make decisions based on what you provide.

Position Applied For

Date of Application

How did you hear about this position?

Please select one ABC Employee Employment Agency Newspaper Ad Relative Trade Magazine Walked in Web Site
If from an ABC employee please enter the name of whom referred you below.

Full Name (Last, First, Middle)

Address

Street

City

State

Zip

Home Phone

Cell Phone

Best time to call

Please select Morning Afternoon Evening
May we contact you at work?

Please select Yes No
Best time
Please select Morning Afternoon Evening
Date Available for work

Are you on Lay-Off and subject to recall?
Please select Yes No

Will you be able to do some travel if the job requires it?
Please select Yes No

Will you be able to work overtime if required?
Please select Yes No

Can you drive a straight shift vehicle?
Please select Yes No

Have you had your Driver’s License for more than 3 years?
Please select Yes No
Driver’s License #

State issued

I understand that a Motor Vehicle Report must be run in order to be eligible for employment with ABC Cutting Contractors.

Digital Signature

Have you been convicted of a Felony in the last 7 Years?

Please select Yes No
(A conviction may be relevant if job related, but does not bar you from employment.)
Do you have any illness or injury that would affect your ability to perform this type of construction work?

Please select Yes No Not Sure
If “Yes” please explain

Employment History
List your last 3 employers starting with the most recent, assignments or volunteer activities beginning with the most recent including military experience.

Employer

Phone

Address

 
Supervisor Name

Date employed
From To
Job Description

Reason for Leaving

May we contact this employer for a reference?

Please select Yes No Later
Hourly rate during this employment:

Start

$ / hour
Final

$ / hour

Employer

Phone

Address

 
Supervisor Name

Date employed
From To
Job Description

Reason for Leaving

May we contact this employer for a reference?

Please select Yes No Later
Hourly rate during this employment:

Start

$ / hour
Final

$ / hour

Employer

Phone

Address

 
Supervisor Name

Date employed
From To
Job Description

Reason for Leaving

May we contact this employer for a reference?

Please select Yes No Later
Hourly rate during this employment:

Start

$ / hour
Final

$ / hour

Please explain any Gaps in employment history:

Skills and Qualifications
Summarize any special skills and qualifications you have acquired from employment, training or other experience that would qualify you to work for ABC.

Educational Background
List the last 3 school you have attended showing the time, field of study and degree earned.
School -Yrs Completed - Diploma - Field of Study

References
List the name and phone# for 3 business references that are not related to you and are not previous employers or supervisors.

Name

Phone

Years Known

Addition comments or information you feel would be relevant:

Name

Phone

Years Known

Addition comments or information you feel would be relevant:

Name

Phone

Years Known

Addition comments or information you feel would be relevant:

It is understood and agreed that any misrepresentation by me on this application will be grounds for sufficient cause for cancellation of this application and or separation from the employer’s services if I have been employed.

I give the employer the right to investigate all references and secure additional information about me, if job related. I hereby release from liability, the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

ABC is an equal opportunity employer. ABC does not discriminate in employment and no question or information on this application is used for the purpose of limiting or excluding an applicant’s consideration for employment on a basis prohibited by local, State or Federal law.

This application will be current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to fill out a new application.

I understand that just as I am free to resign at any time, ABC reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of ABC has the authority to make any assurances to the contrary.
 

By clicking the submit button below you agree the information above is correct and in no way falsified which can result in termination after employment