Employment Application

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Interview Questions

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Hiring Checklist

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I9 Acceptable Documents

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Field Job Description

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Field Job Description (Cont)

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Full Name* This field is required.

First Name

Middle Initial

Last Name

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Current Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Phone Number* This field is required.

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E-mail* This field is required.

example@example.com

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Do you have a valid CA Drivers License?* This field is required.

Yes

No

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If hired, would you have a reliable means of transportation to and from work?* This field is required.

Yes

No

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Are you at least 18 years of age?* This field is required.

Yes

No

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Last 4 Digits ONLY of Social Security Number* This field is required.

xxx-xx-____

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What position are you applying for?* This field is required.

Office

Paving Crew

Sealcoat/Slurry Crew

Striping Crew

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Are you applying for:* This field is required.

Regular full-time work

Regular part-time work

Seasonal work (summer)

Temporary work (less than 90 days)

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If hired, on what date can you start work?* This field is required.

Date

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Other than time off for reasons related to your religion, a disability, or a medical condition, are there any days or times when you are unavailable to work?* This field is required.

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Would you be able to work overtime, if necessary?* This field is required.

Yes

No

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Have you worked here before?* This field is required.

Yes

No

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If so, when did you work here?

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Do you have any friends or relatives working for the company? If so, please list name(s) and relationship.

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Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?* This field is required.We comply with the ADA and we will consider reasonable accommodation measures, for eligible applicants/employees, to perform essential functions.

Yes

No

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If no, please describe the essential functions that cannot be performed.* This field is required.

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Select the highest level of education completed:

High School Diploma / GED

Technical / Vocational School

Bachelor Degree

Graduate Degree (Masters or Doctorate)

Did not complete

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Please explain any experience, training, qualifications or skills you have, that you feel will make you well suited to work for the company. Include any special skills or abilities you may have obtained due to Military Service.* This field is required.

List any relevant skills

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Many of our clients do not speak English. If you speak, write or understand any foreign languages, please list them here: list other languages

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Current or Most Recent Employer* This field is required.

Name of Current or Most Recent Employer

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Your position and duties:* This field is required.

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Start Date* This field is required.

Date

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End Date* This field is required.Use today's date if you are currently employed with this employer

Date

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Reason for Leaving:* This field is required.

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May we contact this employer for a reference?* This field is required.

Yes

No

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If yes, please list your supervisors name and phone number.* This field is required.

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Do you need to list another employer?

Yes

No

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Previous Employer* This field is required.

Name of Previous Employer

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Your position and duties:* This field is required.

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Start Date* This field is required.

Date

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End Date* This field is required.

Date

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Reason for Leaving?* This field is required.

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May we contact this employer for a reference?* This field is required.

Yes

No

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If yes, please list your supervisors name and phone number.* This field is required.

42

Do you need to list another employer?

Yes

No

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Previous Employer* This field is required.

Name of Previous Employer

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Your position and duties:* This field is required.

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Start Date* This field is required.

Date

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End Date* This field is required.

Date

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Reason for Leaving?* This field is required.

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May we contact this employer for a reference?* This field is required.

Yes

No

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If yes, please list your supervisors name and phone number.* This field is required.

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Cover Letter (Optional)

Drag and drop files here

Select files to upload

Max. file size: 10.0MB

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Resume (Optional)

Drag and drop files here

Select files to upload

Max. file size: 10.0MB

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Please Read Carefully, by clicking SUBMIT below, you are agreeing to understanding and accepting the below.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize the company to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment, and further, authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative.

I understand that once a conditional offer of employment is made, I will be subject to passing a drug screen, a position-related medical examination and review of my DMV driving record from the last 5 years.

I understand that once a conditional offer of employment is made, in compliance with federal law, I will be required to verify my identity and my eligibility to work in the United States. I will complete the required Federal employment eligibility verification form.

I understand that if a conditional offer of employment is made, I may be subject to a criminal conviction background check.

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Signature* This field is required.

Clear

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Date* This field is required.

Date