Application For Employment
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
Name
First Name
Middle Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Driver's License #
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you legally eligible for employment in the US?
Yes
No
Are you at least 18 years of age?
Yes
No
Were you referred by a current employee?
Yes
No
Please give the name of the employee
First Name
Last Name
Have you previously been employed by Platinum Concrete Cutting LLC?
Yes
No
Job Preferences
Date available to start
-
Month
-
Day
Year
Date
What position are you applying for?
Concrete Operator
Concrete Operator Helper
Equipment Mechanic
Sales
Schedule Preferences
Full Time
Part Time
Seasonal
Other
Number of hours per week available to work
Hours
Days per week available to work
Days
Answering "Yes" to the following questions will not necessarily disqualify you from employment.
Have you been convicted of, plead guilty, no contest or nolo contendere to a crime within the past 7 years?
Yes
No
Have you ever been charged with a crime and either placed on a court-ordered probation, had adjudication withheld, or entered into a pre-trial intervention program?
Yes
No
If yes, to either of the previous questions, please give details (dates, place, offense (s), etc.)
Work History
Please list your last 3 employers, starting with the most recent.
Work Related Skills
What concrete cutting skills or experience do you have?
Slab Saw
Hand Saw
Wall Saw
Electric Saw
Core Drill
Declaration
I, the applicant undersigned, agree with the following statements:
I declare that all information provided in this form is true and complete.
I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered later.
IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.
I UNDERSTAND MY EMPLOYMENT IS TENTATIVE BASED UPON A SUCCESSFUL COMPLETION OF A 10 YEAR CRIMINAL BACKGROUND CHECK.
I acknowledge that I meet all required qualifications for this position and am able to perform the job responsibilities outlined in the job posting.
Date
-
Month
-
Day
Year
Date
Signature
Submit
Submit
Should be Empty: