Employment Application

List your last two employers, most recent first.

Company 1
Company*
Company Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Job Title*
From (Month/Year):*
To (Month/Year):*
Reason for Leaving*
Company 2
Company*
Company Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Job Title*
From (Month/Year):*
To (Month/Year)*
Reason for Leaving*
Please list two professional references we can contact.
Reference 1
Full Name*
Relationship*
References Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How many years have you known this person?*
Reference 2
Full Name*
Relationship*
References Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How many years have you known this person*

Construction Experience (please provide details of particular skills, e.g., carpentry, masonry, heavy machinery, etc)*
List any special training or certifications you have such as: CDL and what class, welding, CPR, Etc.*
If you have a current resume, please attach it to this application.

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Required only if position involves driving a company vehicle. This information may affect whether or not you can drive a company vehicle.
What states have you held a valid drivers license in?*
1. Do you possess a current valid drivers license?*
Driver's License Information:
State*
Expiration*
Drivers License #*
Full Name*
Other License (CDL, Chauffeur, Etc.):*
If none, please type none in the box.
2. Have you ever had a drivers license revoked or suspended?*

YESNO
If yes, please explain*
3. List all moving violations and collisions you have had written the last 3 years. (If none, please write "none".)*
4. Have you ever received a citation for driving while under the influence of alcohol, drugs, or other controlled substances?*

YESNO
If yes, explain*
5. Have you ever been required to attend an alcohol offender's school, traffic offender's school, or other remedial traffic school required by the courts?*

YESNO
If yes, when? (Date)*

MonthDayYear
Date
6. Have you ever completed any type of advanced driver's safety class?*

YESNO
If yes, what and when?*

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.
Signature*
Date*

MonthDayYear
Date
Jake Wieser Construction, Inc / Wieser Septic & Excavating are an equal opportunity employer with a commitment to affirmative action. We do not discriminate against any individual with regard to age, sex, race, color, religion, sexual orientation, national origin, disability, military service, or any other protected status. Our goal is to provide a diverse and fulfilling work environment free of harassment. Women, minorities and veterans are encouraged to apply for employment.
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