Employment Application

Job Application

Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy, sexual orientation and gender identity), race, color, religion, national origin, age, disability, genetic information, or any other basis protected by federal, state, and/or local law.
Full Name

First NameMiddle NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number (list a number that you can receive text messages on)
Format: (000) 000-0000.
How did you hear about us?

Other
If referred by someone, please list their name.
Position Applying For
Available Start Date

MonthDayYear
Date
Are you available to work full-time? We currently do not offer part-time, temporary, or seasonal positions.
Select all shifts that you are available to work.
You are required to be at least 18 years old to work with our Company. Can you meet that requirement?
Have you previously applied for a position with Columbus Brick or General Shale?
Have you ever been employed by Columbus Brick or General Shale before?
If so, give dates:
What is your desired hourly rate of pay?
Will you work overtime if required?
Have you ever pleaded "guilty" or "no contest" to or been convicted of a crime? NOTE: Answering "yes" to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.
If yes, please provide date(s) and details:
Previous Job Title:
Start Date
End Date
Rate of Pay:
Previous Employer Name:
Summarize the type of work performed and job responsibilities:
Previous Job Title:
Start Date
End Date
Rate of Pay:
Previous Employer Name:
Summarize the type of work performed and job responsibilities:
High School:
Years Completed:
Did you graduate?
College:
Years Completed:
Did you graduate?
Degree Received:
Reference Name (Non-Relative):
Relationship to You:
Phone Number:
Email
example@example.com
Reference Name (Non-Relative):
Relationship to You:
Phone Number:
Email
example@example.com
Upload Resume

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I certify that all information I have provided in order to apply for and secure work with this employer is true, complete, and correct.

Application status will only be shared through the email provided on this application. We do not give out application status updates over the phone and we do not give application status updates to relatives.
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Job Application