Employment Application
Please fill out the form completely for employment consideration. If, because of disability, you require a special accommodation to participate in the application and selection process, please notify the hiring authority in advance. Double D Gravel is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, gender, marital status, national origin, disability or handicap, genetic information, veteran status, or any other protected class. (For assistance, please contact our office during regular business hours at 507-825-5552)
Full Name
*
First Name
Middle Initial
Last Name
Current Address
*
Street Address
Apartment/Unit #
City
State / Province
Postal / Zip Code
Date of Birth
*
/
Month
/
Day
Year
Email Address
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Position Applied For
*
Desired Wage
*
How did you hear about us
*
Please Select
Social Media
Company Website
Family / Friend
Newspaper
Other
Are you atleast 18 years of age?
*
Yes
No
Available Start Date
*
/
Month
/
Day
Year
Are you able to perform the essential functions of the position, with or without accommodation?
*
Yes
No
Are you a citizen of the United States?
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for Double D Gravel?
*
Yes
No
If so, when?
When are you available for work? (Check all that apply)
*
Full Time
Part Time
Over Time
If the position involves driving a vehicle or equipment which requires a license, please list any violations over the last 3 years:
*
Education
High School
*
Did you graduate?
*
Yes
No
College/Other School
City/State
Did you graduate?
Yes
No
Degree
Licenses/Certifications/Special Skills
Do you have a valid driver's license?
*
Yes
No
Do you have a CDL?
*
Yes
No
If yes, specify class:
Class A
Class B
Endorsements:
ex: Passenger, Tanker, Hazardous Materials
Which machines can you operate?
*
Skid Loader
Excavator
Backhoe
Dozer
Straight Truck
Truck/Trailer (Class A)
Mini Excavator
Loader
Screener
What special skills do you have?
*
Current and Previous Employment
Are you currently employed?
*
Yes
No
Company
*
Job Title
*
Supervisor
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities
*
Starting Wage:
*
Ending Wage:
*
To:
*
Ex: August 2020
From:
*
Ex: August 2020
Reason for leaving?
*
May we contact this employer for a reference?
*
Yes
No
Company
*
Job Title
*
Supervisor
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities
*
Starting Wage:
*
Ending Wage:
*
To:
*
Ex: August 2020
From:
*
Ex: August 2020
Reason for leaving?
May we contact this employer for a reference?
Yes
No
Company
Job Title
Supervisor
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsibilities
Starting Wage:
Ending Wage:
To:
Ex: August 2020
From:
Ex: August 2020
Reason for leaving?
May we contact this employer for a reference?
Yes
No
Military Service
Branch
Rank at Discharge
To:
Ex: May 1999
From:
Ex: February 2005
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. Double D Gravel may investigate all statements contained in this application and I understand that any false or misleading information may result in my immediate discharge if hired. I understand that this application is not a contract of employment and if hired, regardless of any oral representations to the contrary, the employment relationship between myself and Double D is terminable at will. I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor or physician assistant selected by the company to determine whether i can perform the essential functions of the job, with or without accomodation. In addition, I understand a drug test may be required. I authorize Double D to make a thorough investigation of my past employment, driving record, and all job-related activities, and I release from all liability all persons, companies, and corporations supplying such information. I also indemnify Double D against any liability which might result from making such investigation. Additionally, I authorize Double D to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party, with an interest that Double D deems appropriate.
Signature
*
Time
Hour Minutes
AM
PM
AM/PM Option
Date
*
-
Month
-
Day
Year
Date
Apply
Should be Empty: