Application for Employment

Application for Employment

Burks-Mordecai Builders is an equal opportunity employer and does not discriminate on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap.
Name*

First NameMiddle NameLast Name
Phone Number*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Resume and Files

Cancelof
Position Desired*
List skills, equipment, tools, and materials you have experience with:
Training and Certifications
Are you 18 years or older?*

YesNo
Schedule*

Full-TimePart-Time
Valid Driver's License*

YesNoNo, but I have transportation
Are you legally eligible for employment in the United States?*

YesNo
Have you ever been employed by Burks-Mordecai Builders?*

YesNo
If so, please state project, location, and dates of employment.
Available Start Date*

MonthDayYear
Date
Wage Desired
Have you ever been convicted of a felony?*

YesNo
If yes, please explain.
Education
High School
Number of years completed
High School Diploma?

YesNo
G.E.D?

YesNo
College and/or Vocational School
Number of years completed
Major
Degree Earned
Do you hold a professional license or certification?

YesNo
Type of License Held
License Number
Expiration Date
Former Employers
Employer #1
Phone Number
Please enter a valid phone number.
Job Position
Dates of Employment
Hourly Rate
Supervisor Name
Job Duties
Reason for Leaving
Employer #2
Phone Number
Please enter a valid phone number.
Job Position
Dates of Employment
Hourly Rate
Supervisor Name
Job Duties
Reason for Leaving
References

Please list two (2) references that are familiar with your work life.
Reference
Reference
How were you referred to us?

Walk-InReferralNewspaper AdFacebookTwitterLinkedInOther
Authorization
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize that a full background check may be performed and also an investigation of all statements contained herein. I further authorize the above references and employers listed to give Burks-Mordecai Builders any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release Burks-Mordecai Builders from all liability for any damage that may result from utilization of such information."
Signature*

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Date*

MonthDayYear
Date
Should be Empty:

Application for Employment

Education

Former Employers

Authorization