Application Form General Employment Application We are an Equal Opportunity Employer First Name:(Required) Middle Name: Last Name:(Required) Address:(Required) City(Required) State(Required) Zip(Required) Home Phone: Mobile Phone:(Required)Email(Required) Are you legally authorized to work in the U.S.? Yes No (If hired, you will be required to provide proof of work authorization.) Are you at least 18 years old? Yes No If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit. Have you ever applied to this company before? Yes No If yes, when: Have you ever worked at this company before? Yes No If yes, when: Position Applying For Salary Preference Date Available How were you referred to the company? Agency Website Friend/Relative Social Media School Other Do you carry any of the below certifications? (proof to be provided in hired) OSHA 10 OSHA 30 First Aid/CPR Boom Lift Scissor Lift Lull Union _______________ Other _______________ Please describe your specific construction experience. Education Example: High SchoolLocation (city, state) Number of Years Attended Major Subjects Diploma or Degree Received Yes No 1) Driver's License Number 2) State Issued 3) Expiration Date If currently employed, may we contact as a reference? Yes No Name of Employer TelephoneAddress Job Title Employment Dates (month/year)Start Date End Date Description of Duties Reason for Leaving Name of Employer TelephoneAddress Job Title Name of Immediate Supervisor Description of Duties Employment Dates (month/year)Start Date End Date Description of Duties Reason for Leaving Please Read Carefully Before Signing This Form All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information about my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment. I understand that upon receiving a job offer, a physical examination and drug screening may be required. (Note: If this is a job requirement, you will be notified.) Regardless of whether or not I become employed by the company, I recognize this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company’s, unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the company, and then only by means of a signed, written document. Date MM slash DD slash YYYY Thank you for your interest in TRI-Construction
