Candidate Information Sheet
What company are you applying to?
*
DEEM, LLC
CSC
Victory Surfaces
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Personal Information
First Name:
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Middle Name:
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Last Name:
*
Date:
*
-
Month
-
Day
Year
Address:
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Street Address
Apartment/Unit #
City
State / Province
Postal / Zip Code
Cell Phone Number:
*
Please enter a valid phone number.
Home Phone Number:
Please enter a valid phone number.
Email Address:
*
example@example.com
Desired Pay:
*
Desired Position/Trade:
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City Location:
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What city would you like to work in?
State Location:
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What state would you like to work in?
How did you find out about this position? If referred, list full name of employee.
*
Are you over the age of 18?
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Yes
No
Are you authorized to work in the United States?
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Yes
No
Some positions require driving a company vehicle, which mandates that drivers be 21 years of age or older due to insurance regulations. If applying for a position that requires driving a company vehicle, are you 21 years of age or older?
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Yes
No
Not applicable (I am not applying for a driving-related position)
Have you ever worked for this company?
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Yes
No
If yes, when? Start Date:
*
If you selected "No" for the previous question, please put N/A in the text box
If yes, when? End Date:
*
If you selected "No" for the previous question, please put N/A in the text box
Job Location
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Education
High School:
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City, State:
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Did you earn a High School Diploma or a GED?
*
Yes
No
If yes, Year of Completion:
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If you selected "No" for the previous question, please put N/A in the text box.
Please check the box next to the valid certification you hold.
OSHA 10
OSHA 30
EPA
TDLR Card
Journeyman license
Other
If you selected Other, please specify the valid certification.
If you have a Journeyman license, please specify for what trade and what state it was issued in.
Please list any degrees, certificates, or licenses earned (e.g., Associate's, Bachelor's, Trade Certificate):
Degree/Certification
Institution
Year of Completion
#1
#2
#3
#4
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Previous Employment
(List your last 3 most recent jobs starting with the most recent.)
Company:
*
Most Recent Company
Phone:
Please enter a valid phone number.
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor:
*
Job Title:
*
Please include your trade along with your job title.
Responsibilities included:
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Please provide a detailed summary of the key tasks and responsibilities you handled in this role.
Start Date:
*
End Date:
*
Reason for Leaving:
*
May we contact your previous employer?
*
Yes
No
Previous Employment #2
Company:
*
Phone:
Please enter a valid phone number.
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor:
*
Job Title:
*
Please include your trade along with your job title.
Responsibilities included:
*
Please provide a detailed summary of the key tasks and responsibilities you handled in this role.
Start Date:
*
End Date:
*
Reason for Leaving:
*
May we contact your previous employer?
*
Yes
No
Previous Employment #3
Company:
*
Phone:
Please enter a valid phone number.
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor:
*
Job Title:
*
Please include your trade along with your job title.
Responsibilities included:
*
Please provide a detailed summary of the key tasks and responsibilities you handled in this role.
Start Date:
*
End Date:
*
Reason for Leaving:
*
May we contact your previous employer?
*
Yes
No
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Military Service
If you did not serve in the military, please skip this page by pressing next at the bottom.
Military Branch:
From:
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Month
-
Day
Year
To:
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Month
-
Day
Year
Rank at Discharge:
Please describe responsibilities at this rank.
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Professional References
Please list three professional references. Someone whom you have known for at least a year and is not related to you.
Full Name:
*
Relationship:
*
Company:
*
Phone Number:
*
Please enter a valid phone number.
Email Address:
*
Professional References #2
Full Name:
*
Relationship:
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Company:
*
Phone Number:
*
Please enter a valid phone number.
Email Address:
*
Professional References #3
Full Name:
*
Relationship:
*
Company:
*
Phone Number:
*
Please enter a valid phone number.
Email Address:
*
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Resume Upload
To help us match you with the best opportunities, please upload your most recent resume.
Resume Upload
Browse Files
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Choose a file
To help us match you with the best opportunities, please upload your most recent resume.
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Disclaimer and Signature
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.
Name:
*
First Name
Middle Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Signature:
*
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