Employment Application Form

Application for Employment
Personal Information:
Name: *

First Name Last Name
Phone Number: *

Area Code Phone Number
E-mail Address:
Address: *

Street Address

Street Address Line 2

City State

Zip Code
Over 18 years old? *

Yes No
Education
High School (Select Highest Year Complete)

9 10 11 12
College (Select Highest Year Complete)

1 2 3 4
Other Training, Certifications or Licenses Held:
Past Employers (REQUIRED: List last four employers, without skipping any, starting with the latest one first):
Employer 1
Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Dates of Employment *
Start date - end date
Reason for Leaving *
May we contact them? *

Yes No Later
Employer 2
Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Dates of Employment *
Start date - end date
Reason for Leaving *
May we contact them? *

Yes No Later
Employer 3
Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Dates of Employment *
Start date - end date
Reason for Leaving *
May we contact them? *

Yes No Later
Employer 4
Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Dates of Employment *
Start date - end date
Reason for Leaving *
May we contact them? *

Yes No Later
Professional References List at least one. Ex: Pastor, Teacher, Mentor
Reference 1
Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Reference 2
Name:

First Name Last Name
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State

Zip Code
What type of employment are you seeking? *

Full Time Full Time Temporary (i.e. summer job)
This job requires out-of-town travel and work. Does that present any challenges for you? *
Yes or No (Explain)
You may be asked to travel out of town or work overtime on short notice. Would this be a problem for you? *
Yes or No (Explain)
A typical work day begins around 6 AM. Would this be a problem for you? *
Yes or No (Explain)
All crew members take turns driving company trucks to and from jobs. Would this be a problem for you? *
Yes or No (Explain)
What construction experience do you have? *
Yes or No (Explain)
Which types of power tools are you experienced at operating? (ex: partner saw, circular saw, etc...) *
Yes or No (Explain)
Which types of heavy equipment are you experienced at operating? (ex: fork-lift, man-lift, etc...) *
Yes or No (Explain)
Are you willing to learn how to operate equipment and machinery you are inexperienced with? *
Yes or No (Explain)
The ability to lift heavy objects is required for this job. Would this be a problem for you? *
Yes or No (Explain)
The ability to make regular trips up and down ladders is required for this job. Would this be a problem for you? *
Yes or No (Explain)
Drug screening is required for hire. Are you willing to do a drug screening? *
Yes or No (Explain)
If you are hired, you may be subjected to random drug screening. Is this a problem for you? *
Yes or No (Explain)
A functional fitness test is required for hire. Would this be a problem for you? *
Yes or No (Explain)
When would you be able to start working? *

Month Day Year
Date
Skills
What measurement is the arrow pointing to in thee picture above? *
Identify the following tools:
*
*
*
Additional Information: (optional) Please use this space to tell us anything more about yourself that you would like us to consider when going through the hiring process.
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature *

Clear
Date

Month Day Year
Date
Should be Empty:

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