Environmental Services Technician Employment Application
Complete this application, upload your resume and license documents, and answer the role and safety questions.
Personal Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
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Angola
Anguilla
Antigua and Barbuda
Argentina
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Canada
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Chile
China
Christmas Island
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Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Denmark
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Ecuador
Egypt
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Eritrea
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Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
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Germany
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Iran
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Japan
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Liberia
Libya
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Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Trinidad and Tobago
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Tunisia
Turkey
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Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred Contact Method
Please Select
Phone
Email
Text Message
Mail
Other
Earliest Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Schedule Restrictions or Availability Notes
Driver License and CDL Information
Do you currently hold a CDL?
*
Yes
No
Endorsements
Endorsement types held
H
N
T
P
S
Tank Vehicle (N)
Passenger (P)
School Bus (S)
Doubles/Triples (T)
Other
Endorsement notes or restrictions
Employment Eligibility
Are you legally authorized to work in the United States?
*
Yes
No
Will you now or in the future require employer sponsorship for work authorization?
*
No
Yes, now
Yes, in the future
Unsure
Work authorization details or status notes
Employment History
Employment History Entries
*
Education
Education History
*
Highest Level of Education Completed
Field of Study / Major
Please Select
Environmental Science
Environmental Technology
Biology
Chemistry
Engineering
Business
General Studies
Other
Expected or Actual Graduation Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional Education Details
Skills Matrix
Experience Level: Hydro Excavation
*
Rows
No Experience
Basic
Intermediate
Advanced
Hydro Excavation
Experience Level: Combo Truck
*
Rows
No Experience
Basic
Intermediate
Advanced
Combo Truck
Experience Level: Jetting
*
Rows
No Experience
Basic
Intermediate
Advanced
Jetting
Experience Level: Storm Sewer
*
Rows
No Experience
Basic
Intermediate
Advanced
Storm Sewer
Experience Level: CCTV
*
Rows
No Experience
Basic
Intermediate
Advanced
CCTV
Experience Level: Locating
*
Rows
No Experience
Basic
Intermediate
Advanced
Locating
Experience Level: Flagging
*
Rows
No Experience
Basic
Intermediate
Advanced
Flagging
Experience Level: Traffic Control
*
Rows
No Experience
Basic
Intermediate
Advanced
Traffic Control
Experience Level: CIPP
*
Rows
No Experience
Basic
Intermediate
Advanced
CIPP
Experience Level: Manhole Rehab
*
Rows
No Experience
Basic
Intermediate
Advanced
Manhole Rehab
Experience Level: Shop/Mechanical
*
Rows
No Experience
Basic
Intermediate
Advanced
Shop/Mechanical
Experience Level: Welding
*
Rows
No Experience
Basic
Intermediate
Advanced
Welding
Experience Level: Excavation
*
Rows
No Experience
Basic
Intermediate
Advanced
Excavation
Experience Level: Construction
*
Rows
No Experience
Basic
Intermediate
Advanced
Construction
Experience Level: Industrial
*
Rows
No Experience
Basic
Intermediate
Advanced
Industrial
Experience Level: Confined Space
*
Rows
No Experience
Basic
Intermediate
Advanced
Confined Space
Experience Level: OSHA
*
Rows
No Experience
Basic
Intermediate
Advanced
OSHA
Experience Level: First Aid / CPR
*
Rows
No Experience
Basic
Intermediate
Advanced
First Aid / CPR
Experience Level: Forklift
*
Rows
No Experience
Basic
Intermediate
Advanced
Forklift
Experience Level: Excavator and Loader
*
Rows
No Experience
Basic
Intermediate
Advanced
Excavator and Loader
Certifications and Equipment Operated
Certifications held
HAZWOPER
OSHA 10/30
First Aid/CPR
Forklift
CDL
Confined Space
Fall Protection
Other
Certification or license name
Issuing organization
Date issued
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Expiration or renewal date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment operated experience
Career Interest and CDL Intent
Desired career path
*
Please Select
Environmental Services Technician
CDL Driver
Apprenticeship Track
Lead Technician
Equipment Operator
Supervisor/Foreman
Other
Willing to obtain a CDL if required
*
Yes
No
Maybe
Notes on apprenticeship, advancement goals, or related interests
Introduction and Personal Statement
Safety and Compliance
Can you perform the essential physical requirements of the position, with or without reasonable accommodation?
*
Yes
No
Acknowledgment of safety and compliance requirements
*
Uploads and Signatures
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