JOB APPLICATION

JOB APPLICATION
Coastal Laser Grading
LLC 29 Southern Ct
Hiram, Georgia 30141 3215089018

Coastal Laser Grading, LLC is an equal-opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below:
City State and Zip Code*
Address*
Applicant Name*
Telephone Number*
Email Address*
example@example.com
Date of Application*

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Date
Employment Position Position(s) applying for:
How did you hear about this position*
On what date can you start working if you are hired*

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Are you a U.S. citizen or approved to work in the United States?
What document can you provide as proof of citizenship or legal status*
Job SkillsQualifications*
Job Skills/Qualifications Please list below the skills and qualifications you possess for the position for which you are applying:

(Note: Coastal Laser Grading, LLC complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions

Education and Training High School Name
Name
Location City State
Year Graduated
Degree Earned
Name
Location City State
Year Graduated
Degree Earned
Vocational School/Specialized Training Name
Name
Location City State
Year Graduated
Degree Earned
Military
Are you a member of the Armed Services
What was your military rank when discharged
What branch of the military did you enlist
How many years did you serve in the military
What military skills do you possess that would be an asset for this position
Previous Employment Employer Name: Job Title:
Job Title
Employer Name
Supervisor Name: Employer Address: City, State and Zip Code: Employer Telephone: Dates Employed: Reason for leaving
City State and Zip Code
Employer Address
Supervisor Name
Dates Employed

MonthDayYear
Date
Reason for leaving
Employer Name
Supervisor Name: Employer Address: City, State and Zip Code: Employer Telephone: Dates Employed: Reason for leaving
Supervisor Name
Job Title
Employer Address
City State and Zip Code
Dates Employed

MonthDayYear
Date
Reason for leaving
Job Title
Employer Name
Supervisor Name: Employer Address: City, State and Zip Code: Employer Telephone: Dates Employed: Reason for leaving
Address

Employer Address

Street Address Line 2

City State and Zip CodeState / Province

Postal / Zip Code
Supervisor Name
Reason for leaving
Dates Employed

MonthDayYear
Date
The relationship between you and the Coastal Laser Grading, LLC is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Coastal Laser Grading, LLC. No representative of Coastal Laser Grading, LLC has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
Applicant Signature*

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Dated*

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