EMPLOYEE APPLICATION
HOME OFFICE USE ONLY: NEW HIRE or REHIRE
NEW HIRE
REHIRE
EMPLOYEE NUMBER
OCC CODE
HIRE DATE
/
Month
/
Day
Year
Date
HOURLY RATE
SALARY
TITLE
PTO
Completed the following?:
W-4 Form
VA-4 Form
E-Verify Complete
I-9 Forms
Background Check Form
Drug Test
Direct Deposit
Company Property Form
State New Hire Reporting Center
Exempt of Non-Exempt
Protected Veteran Status
Disability
IDENTIFICATION PROVIDED
IDENTIFICATION PROVIDED
Social Security Card
Driver's License. State I:D. Card
Birth Certificate
Passport
EMPLOYEE APPLICATION
Desired Work Location (Select One):
Richmond, VA
Hampton, VA
Trade
Ironworker
Pipefitter
Millwright
Trade Description
General Foreman
Foreman
Journeyman
Apprentice
Laborer
Union
Application Date
*
/
Month
/
Day
Year
Date
Hiring Manager
Name
*
(Last, First, Middle Initial )
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Gender
*
Please Select
Male
Female
Non-Binary
Transgender
Cell Phone Number
*
Email Address
*
example@example.com
Race
*
Please Select
White (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Hispanic or Latino
Asian (Not Hispanic or Latino)
Native Hawaiian or Other Pacific Islander (Not Hispanic or Lalino)
American Indian or Alaskan Native (Not Hispanic or Lalino)
Two or more races (Not Hispanic or Lalino)
Veteran Status
*
Please Select
N / A
Disabled Vet
Recently Separated Vet
Active Duty or Wartime Campaign Vet
APPLICANT INFORMATION FORM
Name
Home Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Phone #
Cell #
Email
example@example.com
I certify that I am over 18 and have voluntarily provided the above contact information.
Employee Signature
Date
/
Month
/
Day
Year
Date
Save
SUBMIT APPLICATION
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