AF Application for Employment

Previous Employers
Your application will not be considered unless every question in this section is filled out. The telephone numbers you list must be correct.
Most Recent Employer:
Are you currently working for this employer?
If yes, may we contact them?
Company Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
from
to
Job Title:
Supervisor's Name:
Duties:
Reason for Leaving:
Phone Number:
Format: (000) 000-0000.
Second Most Recent Employer:
Company Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
from
to
Job Title:
Supervisor's Name:
Duties:
Reason for Leaving:
Phone Number:
Format: (000) 000-0000.
Third Most Recent Employer:
Company Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
from
to
Job Title:
Supervisor's Name:
Duties:
Reason for Leaving:
Phone Number:
Format: (000) 000-0000.
Education History

Education History

Rows	School	Did you graduate?	Dates Attended (Years)	City and State	Degree or Diploma
1
2
3

Skills, Licenses, and Certifications

Complete the following based on your years of experience and skill level. If no experience with a particular item, leave that portion blank. Upon employment offer, you will be required to provide valid, unexpired certification cards for any of the skills listed below. Please note that possession of a skill, certification, or license does not exempt you from any required company, client, or job-specific training, which may still be required upon hire.
Use the following guideline for skill level:
A: Senior Level / Capable of Training Others
B: Intermediate Skills
C: Strong Skills
D: Entry Level

Skill/Certification

Rows	Years	Skill Level	Description for Other Skill/Certification
24- Hour Fall Protection
Competent Person Certification
Confined Space Entry
CPR/ First Aid
DPOR License(s)
LOTO (Lock Out Tag Out)
MEWP (Mobile Equip. Work Platform)
NCCCO Crane Operator
Rigger Signal Person
Basic Rigging
OSHA 10
OSHA 30
PIT (Power Industrial Trucks)
Respirator Fit Test
Scaffolding Inspector
TWIC Card
Other
Other
Other
Other

Office Skills

Rows	Years	Skill Level	Description for Other Skill/Certification
Microsoft Word
Microsoft Excel
AutoCAD Software
ERP
Other

Supervisory Skills
Did you work in the field or office?
How long?
The largest team you've managed?
Other Supervisory Duties:

References
(List names of three persons not related to you, who you have known for at least one year.)

References (List names of three persons not related to you, who you have known for at least one year.)

Rows	Name	Phone Number	Years Known	Address	Relationship
1
2
3

Emergency Point of Contact:
(You must list two persons.)

Emergency Point of Contact: (You must list two persons.)

Rows	Name	Mobile Number	Home Number	Address	Relationship
1
2

Authorization
I certify that all information provided in this employment application, resume, and any supporting documentation is true, complete, and accurate to the best of my knowledge. I understand that any false statements, omissions, or misrepresentations may disqualify me from consideration for employment or, if discovered after employment begins, may result in disciplinary action up to and including termination of employment.

I authorize the Company to verify the information contained in this application and to conduct lawful inquiries regarding my qualifications for employment, including verification of prior employment, education, professional references, licenses, certifications, and other relevant job-related information.

I authorize former employers, educational institutions, references, and other relevant individuals or organizations to provide information concerning my qualifications, and I release such parties and the Company from liability for providing or obtaining such information in good faith and in accordance with applicable law.

I understand that any offer of employment may be contingent upon successful completion of lawful pre-employment requirements, which may include verification of identity and authorization to work in the US, reference checks, job-related testing, background and drug screening, or other screening procedures permitted by applicable federal, state, and local laws.

I understand that, if hired, I will be required to provide documentation establishing my identity and authorization to work in the US in compliance with the requirements of U.S. Citizenship and Immigration Services Form I-9 and applicable federal law.

I understand that nothing contained in this application, during the interview process, or in any Company policy, handbook, or communication is intended to create, nor shall be construed to create, a contract of employment.

If employed, I understand that employment with the Company is at-will, meaning that the Company or I may terminate the employment relationship at any time, with or without notice, and with or without cause, subject to applicable law.

I understand that completion of this application does not guarantee employment or an offer of employment.

The Company is committed to equal employment opportunity and does not discriminate in employment decisions in accordance with applicable federal, state, and local laws.

By signing below, I acknowledge that I have read, understand, and agree to the statements above.
Signature
Name

First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

Application for Employment

Personal Information

Employment Desired

U.S. Military Service

Previous Employers

Most Recent Employer:

Second Most Recent Employer:

Third Most Recent Employer:

Education History

Skills, Licenses, and Certifications

Supervisory Skills

References

Emergency Point of Contact:

Authorization