Site Safe Solutions, LLC provides equal employment opportunity to all persons regardless of race, age, color, religion, national origin, citizenship status, sex, gender, sexual orientation, gender identity and/or expression, genetic information, marital status, physical or mental disability, military status, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Site Safe Solutions, LLC will provide reasonable accommodations for qualified individuals with disabilities.
Employment Application
Position Applied For
Field Tech
DOT Driver
Supervisor
Other
Name
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Social Security Number
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Phone Number
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Email
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you legally authorized to work in the United States?
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Yes
No
Type of Employment Desired
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Full Time
Part Time
Highest Level of Education Completed
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High School
Trade
Associates
Bachelors
Have You Had Any Felony Convictions?
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No
Yes, List Date and Details
Have You Had Any Misdemeanor Convictions?
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No
Yes, List Date and Details
Have You Worked For This Company Before?
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No
Yes, List Date and Details
Are You Presently Employed?
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Yes
No
If Yes, May We Contact Your Current Employer?
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Yes
No
Drivers License Information
Employment History
Current or most recent employer - Please attach a resume if available.
1st Previous Employer
Contact Name and Number
2nd Previous Employer
Contact Name and Number
3rd Previous Employer
Contact Name and Number
4th Previous Employer
Contact Name and Number
5th Previous Employer
Contact Name and Number
Resume and Files
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How were you referred to us?
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Walk-In
Referral
Newspaper Ad
Facebook
Twitter
LinkedIn
Other
Notice of Drug and Alcohol Testing
I understand that I must submit to Site Safe Solutions controlled substance and alcohol testing program and to provide biological samples to be tested. Controlled substances include, but are not limited to marijuana, cocaine, amphetamines, opiates, and phencyclidine. Site Safe Solutions may contract with a third party to obtain, analyze, and report on the samples provided. A positive controlled substance, and/or alcohol test, or refusal to test, will disqualify me from consideration for employment or will result in my termination if employed. Site Safe Solutions will also release this information to third parties upon receipt of a properly executed release document. A positive result or a refusal on a post-accident test may also result in denial of any Workers Compensation claims I make due to any injury sustained in an accident. My initials authorize Site Safe Solutions to withhold the cost of pre-employment tests if I terminate employment within 60 days of my hire date.
Notice of Drug and Alcohol Testing
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Agreement to Abide by All Rules
If employed, I agree to adhere to all rules, policies, guidelines, procedures, regulations, and statutes promulgated by or issuing from Site Safe Solutions OR local, state, or federal regulatory agencies. I understand that there is no expectation of privacy for any of my personal property on Site Safe Solutions premises, including vehicles. I consent to and agree that Site Safe Solutions may inspect my personal property, along with desks, lockers, toolkits, etc., to investigate possible violations of Site Safe Solutions rules, policies, guidelines, procedures or local, state, or federal regulations or statutes.
Agreement to Abide by All Rules
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At-Will Employment
If employed, I agree to adhere to all rules, policies, guidelines, procedures, regulations, and statutes promulgated by or issuing from Site Safe Solutions OR local, state, or federal regulatory agencies. I understand that there is no expectation of privacy for any of my personal property on Site Safe Solutions premises, including vehicles. I consent to and agree that Site Safe Solutions may inspect my personal property, along with desks, lockers, toolkits, etc., to investigate possible violations of Site Safe Solutions rules, policies, guidelines, procedures or local, state, or federal regulations or statutes.
At-Will Employment
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