• Job Application Form

    Please Fill Out the Form Below to Submit Your Job Application!

  • Notice:

    Pre-employment Drug Testing is required for all positions. In compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Do you have the legal right to work in the United States?*

  • Experience

  • Driver's License: State:   License #:       Class:    Endorsements:   Expiration Date:   

  • Have you ever been denied a license, permit or privilege to operate a motor vehicle?*
  • Has any license, permit or privilege ever been suspended or revoked?*
  • Any CMV/CDL Driving Experience?
  • Have you operated any of the following types of equipment?
  • Do you have any underground utilities construction experience?*

  • Employment History

    All applicants must provide the following information on all employers during the preceding three years. List mailing address, street number, city, state, & zip code. List employers in reverse order starting with the most recent. Add another sheet as necessary.

  • Notice:

    Applicants applying to drive a commercial motor vehicle as defined by Part 383, in intrastate or interstate commerce shall also provide an additional seven years information on those employers for whom the applicant driver operated such vehicle.
  • Were you subject to the Federal Motor Carrier's Safety Regulations** while employed?*
  • Was your job designated as a safety-sensitive function in any DOT-Regulated Mode subject to the Drug & Alcohol Testing requirements of 49 CFR Part 40?*
  • Were you subject to the Federal Motor Carrier's Safety Regulations** while employed?
  • Was your job designated as a safety-sensitive function in any DOT-Regulated Mode subject to the Drug & Alcohol Testing requirements of 49 CFR Part 40?
  • Were you subject to the Federal Motor Carrier's Safety Regulations** while employed?
  • Was your job designated as a safety-sensitive function in any DOT-Regulated Mode subject to the Drug & Alcohol Testing requirements of 49 CFR Part 40?

  • FAIR CREDIT REPORTING ACT DISCLOSURE STATEMENT

    In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, of Public Law 104-208), you are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations.

  • TO BE READ AND SIGNED BY APPLICANT

    I authorize you to make such investigations and inquires of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) & (e). I understand that I have the right to: - Review information provided my previous employers;- Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and- Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. This certifies that this application was completed by me, and that all entries on it are true and complete to the best of my knowledge.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • FOR ALL CDL APPLICANTS:

    CONSENT FOR LIMITED QUERIES OF THE FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION (FMCSA) DRUG & ALCOHOL CLEARINGHOUSE

  • I,         , hereby provide consent to Amerine Utilities Construction, Inc. (AUC) to conduct a limited query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse (Clearinghouse) to determine whether drug or alcohol violation information about me exists in the Clearinghouse. This authorizes a single limited query for pre-employment purposes as required by the FMCSA. I understand that if the limited query conducted by AUC indicates that drug or alcohol violation information about me exists in the Clearinghouse, FMCSA will not disclose that information to AUC without first obtaining additional specific consent from me. I further understand that if I refuse to provide consent for AUC to conduct a limited query of the Clearinghouse, AUC must prohibit me from performing safety-sensitive functions, including driving a commercial motor vehicle, as required by FMCSA’s drug and alcohol program regulations.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: