Employee Contact Form

Potential Employee Contact Form

Please fill out the following information before your visit to our office.
Full Name

First NameLast Name
D.O.B.

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Emergency Contact
How did you find out about us?
Social Media
Who referred you?
Please tell us more:
Name of the person or company that referred you
Do you have experience in construction?
What type of construction work have you done?

Other
Describe your work experience
Have you worked as a traffic flagger or in traffic control before?
What was your role in traffic control? (Select all that apply)

Other
Do you currently hold a valid traffic control certification?
Please upload a photo of your current traffic control certification (flagger card)

Cancelof
Desired Hourly Wage
Desired Hourly Wage
When can you start working?

MonthDayYear
Date
What shifts are you available for?

Other
What days are you available?
Do you have your own transportation?
I certify that the information provided in this form is true and correct to the best of my knowledge. I understand that providing false, misleading, or incomplete information may result in disqualification from employment opportunities and could have legal consequences. I take full responsibility for the accuracy of my answers and acknowledge that any irresponsible or illegal actions will be my own liability.
Agreement
Signature
Should be Empty:

Potential Employee Contact Form