Flatworks Concrete Construction, LLC Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital status, familial status, genetic information, veteran status, sexual orientation, or any other legally protected status.
Position Applying for:
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Date of Application
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Month
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Day
Year
Date
How did you hear about us?
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Employment Agency
Friend
Relative
Walk-in
Other
Name
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First Name
Middle Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
If you are under 18 years of age, can you provide required proof of your eligibility to work?
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Yes
No
Have you ever filed an application with us before?
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Yes
No
If yes, give date
Have you ever been employed with us before?
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Yes
No
If yes, give date
Are you currently employed?
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Yes
No
May we contact your present employer?
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Yes
No
What date are you available to start work
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Are you available to work:
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Full time
Part time
Shift work
Temporary
Are you currently on “lay-off” status and subject to recall?
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Yes
No
Can you travel if a job requires it?
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Yes
No
Are you a veteran?
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Yes
No
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Name/address
course of study
Years completed
Diploma/degree
Elementary School
High School
Undergraduate
College
Graduate Professional
Other (specify)
Indicate any foreign languages you can speak, read and/or write
Fluent
Good
Fair
Speak
Read
Write
Describe any specialized training, apprenticeship, skills andextra-curricular activities.
Describe any job-related training received in the UnitedStates military.
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Past Employment
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Employer
Address
Supervisor
Phone Number
Supervisor
Job Title
Work Performed
Dates employed
Salary
Reason for leaving
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Employer
Address
Supervisor
Phone Number
Supervisor
Job Title
Work Performed
Dates employed
Salary
Reason for leaving
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Employer
Address
Supervisor
Phone Number
Supervisor
Job Title
Work Performed
Dates employed
Salary
Reason for leaving
Please disclose any prior employment terminations or other disciplinary action you have received for threats of violence.
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List professional, trade, business or civic activities and offices held.You may exclude membership which would reveal race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, familial status, genetic information, or any other legally protected status:
Other Qualifications-Summarize special job-related skills and qualifications acquired from employment or other experience.
State any additional information you feel may be helpful to us in consideringyour application.
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached.
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Yes
No
References
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Name
Address
Phone
Name
Address
Phone
Name
Address
Phone
Applicant’s Statement _______________________________________________________________________________________________I certify that answers given herein are true and complete to the best of my knowledge.I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.I hereby understand that this position is subject to the requirements of state/federal drug testing rules that the Company may condition any offer of employment upon the successful passing of a drug and alcohol test and background check.
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Yes
No
Please verify that you are human
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