TCP Employment App

TCP Concrete Construction Inc.

EQUAL OPPORTUNITY EMPLOYER
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.
Position(s) Applied For
Date

MonthDayYear
Date
Are you available to work

Full TimePart TimeShift WorkTemp Work
How did you learn about us?

AdvertismentEmployment AgencyFriendRelativeWalk-inOther
Years of Commercial Concrete Construction Experience
Name

First NameMiddle NameLast Name
Social Security Number
Address
City
State
Zip
Telephone Number(s)
If you are under 18 years of age, can you provide required proof of eligibility to work?

YesNo
Have you ever been employed with us before?

YesNo
If YES, date

MonthDayYear
Date
Can you work as a team player

YesNo
Are you currently employed?

YesNo
May we contact your present employer?

YesNo
Are you on "layoff" status and subject to recall?

YesNo
Are you prevented from lawfully becoming employed in this country because of VISA or Immigration Status? Proof of Citizenship or Immigration Status will be required upon employment.

YesNo
On what date will you be available for work

MonthDayYear
Date
Are you willing to work on a schedule that will require very early or very late start and or stop times?

YesNo
Can you travel if a job requires it?

YesNo
Do you have transportation to work?

YesNo
Do you have a valid drivers license?

YesNo
Do you have a valid drivers licence? STATE ABBREVIATION ONLY
DRIVERS LICENSE NUMBER

Education

	Name City & State	Course of Study	Years Completed	Degree/Diploma
Elementary/Middle
High School
Undergraduate
Graduate
Other

Indicate any foreign languages that you can speak, read, and or write:

	Fluent	Good	Fair
Speak
Read
Write

Describe any specialized training, apprenticeship, skills, and extracurricular activities
Describe any job related training received in the United States Military

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender. national origin, disabilities or other protected status.If you need additional space, please continue on a separate sheet of paper.

	Employer Name City & State	Phone Number	Dates	Salary	Work Performed
Current
Most Recent
Recent
Less Recent

List professional, trade, business, or civic activities and or offices held. You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry. disability, or other protected status.
Other Qualifications Summarize special job related skills and qualifications acquired from employment or other experience
Read Blue PrintsItem 2Item 3Other: Item 5Other: Other Concrete Finishing Skills: Do you have tools, if so which ones?:

Specialized Training/Equipment Experience: What are you qualified to operate?

	Click if qualified
Read Blue Prints
Roller

Other
Other
Other Concrete Finishing Skills:
What tools do you have available for use:
Have you been convicted of a felony within the last 7 year?

YesNo
If "Yes" explain the felony.
Have you ever been convicted of a felony or other offense that would impair your ability to obtain a background check for working in a high security area?

YesNo
Are you currently under probation or do you report to a probation officer?

YesNo
Have you been injured on the job

YesNo
If "Yes" to injured on the job, explain

Please provide 3 references below:

	Reference Name	Reference Phone Number	Reference Address
1
2
3

State below what you believe you can contribute to the company if you are hired as well as your capabilities of performing pertaining to concrete construction
Reason for Applying
EMERGENCY CONTACT INFORMATION
Please provide below the name, relationship, and best daytime/nighttime phone number of the person to contact in case of an emergency.
Name
Relationship
Phone Numbers
DRUG SCREENING INFORMATION
I UNDERSTAND I WILL BE SUBJECT TO A DRUG SCREEN TEST AND WILL BE TESTED AT RANDOM INTERVALS IN ACCORDANCE WITH NC DOT REGULATIONS. I FURTHER UNDERSTAND IF I AM TESTED WITH A POSITIVE

RESULT FOR SUBSTANCE ABUSE, I WILL BE TERMINATED IMMEDIATELY.

THE ABOVE INFORMATION IS CORRECT TO THE BEST OF MY KNOWLEDGE.
Applicant Signature

Clear
Should be Empty:

TCP Concrete Construction Inc.

EMERGENCY CONTACT INFORMATION

DRUG SCREENING INFORMATION