| We are an Equal Opportunity
Employer. Employment decisions are made without
regard to race, color, creed, religion, age,
sex, marital status, national origin, disability,
or veteran status. |
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| Attach
resume: (This must be a .doc .pdf .wpd or .txt file) |
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| What
position are you applying for? |
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| How did you learn about
us? (check one and provide more information where
indicated) |
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| First
Name |
Middle
Name |
Last
Name |
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| Address |
City |
State |
Zip |
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| Email |
Phone |
Cell/Pager/Other
Number |
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| Social Security # |
Min. Salary Requirement |
Date Available to Start |
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| If you are under 18, can you provide
required verification of your eligibility to work? |
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Yes
No
N/A |
| If employed, can you provide required
verification of your eligibility to work in the
United States? |
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Yes
No
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| If the position requires driving
a vehicle, can you provide verification of valid
driver's license? |
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Yes
No |
| Have you ever worked for our company? |
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Yes
No |
If yes, when? |
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| Have you ever been convicted of a
felony? |
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Yes
No |
(Conviction will
not necessarily disqualify you for employment.) |
| If yes, please explain: |
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| Schedule Availability |
| Please tell us when you would be
available to work. |
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| Are there any hours, shifts or days
(including weekends) you cannot or will not work? |
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| Is there anything that would interfere
with your regular attendance and punctuality if
you were offered a job? |
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Yes
No |
| If yes, please explain: |
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| Record of Employment |
| Include Military Service |
| May we contact your current employer? |
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Yes
No |
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| Current Employer |
Address |
Telephone |
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| Date Started |
Starting Salary |
Starting Position |
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| Date Left |
Salary on Leaving |
Ending Position |
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| Name and Title of Supervisor |
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| Description of Duties |
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| Reason for Leaving |
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| Previous Employer |
Address |
Telephone |
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| Date Started |
Starting Salary |
Starting Position |
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| Date Left |
Salary on Leaving |
Ending Position |
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| Name and Title of Supervisor |
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| Description of Duties |
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| Reason for Leaving |
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| Previous Employer |
Address |
Telephone |
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| Date Started |
Starting Salary |
Starting Position |
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| Date Left |
Salary on Leaving |
Ending Position |
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| Name and Title of Supervisor |
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| Description of Duties |
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| Reason for Leaving |
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| Previous Employer |
Address |
Telephone |
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| Date Started |
Starting Salary |
Starting Position |
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| Date Left |
Salary on Leaving |
Ending Position |
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| Name and Title of Supervisor |
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| Description of Duties |
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| Reason for Leaving |
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| Additional work or volunteer experience |
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| Please explain gaps in work history |
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| Have you ever been discharged or
asked to resign from a job? |
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Yes
No |
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| If yes, please explain |
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| Education/Training |
| HIGH SCHOOL |
| Number of years completed (choose
one):
1
2
3
4 |
| Diploma
Yes
No |
OR |
GED
Yes
No |
| COLLEGE AND/OR VOCATIONAL
SCHOOLS: |
| Number of years completed (choose
one)
1
2
3
4 |
| School |
City/State |
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| Major |
Degree Earned |
Date |
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| Number of years completed (choose
one)
1
2
3
4 |
| School |
City/State |
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| Major |
Degree Earned |
Date |
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| Other Training or Degrees: |
| School |
City/State |
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| Course/Major |
Degree/Certification Earned |
Date |
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| Additional Skills/Accomplishments |
| Licenses, Apprenticeships or Certifications |
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| Other Skills |
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Keyboard
Calculator
Computer
Software |
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Equipment
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| Awards |
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| Professional Memberships |
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| Other Skills/Qualifications |
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| Business References |
| Please list the names and information
of individuals who could provide information about
your suitability for work (For example: teachers,
counselors, community or volunteer service leaders,
co-workers, etc.) Please do not include family
members. |
| Name |
Relationship |
Telephone |
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| Email |
How long have you known him or her? |
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| Name |
Relationship |
Telephone |
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|
| Email |
How long have you known him or her? |
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| Name |
Relationship |
Telephone |
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| Email |
How long have you known him or her? |
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| CERTIFICATION AND
AUTHORIZATION |
Since employment at this company
is based upon mutual agreement, either the employee
or Boling Concrete Construction may terminate employment
at any time and for any reason. In consideration
of my employment, I accept the rules and regulations
of Boling Concrete Construction and will obey them.
I further acknowledge the right of Boling Concrete
Construction to change either my job assignment
or my hours of work, or both. I understand that
no supervisor, officer, agent, or representative
of Boling Concrete Construction, other than its
President, has any authority to enter into any
agreement for employment for any period of time,
or to make any agreement contrary to the foregoing.
In addition, I understand and agree that this
application shall be valid for a period of 30
days. If I wish to be considered after 30 days,
I recognize that I must complete a new application
for employment.
I grant permission to Boling Concrete Construction
to investigate my personal, educational, and
work histories thoroughly. In addition, I authorize
Boling Concrete Construction to confirm all information
that I have given in connection with my application
for employment. I, furthermore, release Boling
Concrete Construction and its agents from liability
for any acts or omissions occurring during either
such investigation or confirmation, or both.
I further release any one or more of individuals,
organizations and their agents, educational institutions
that I attended and their agents, or my former
employers and their agents from any liability
for any acts or omissions occurring in its or
their responses to Boling Concrete Construction's
inquiries about me. This release specifically
covers the employers and their agents and the
educational institutions and their agents that
I have identified in my responses to the inquiries
made on this application form. I understand and
agree that Boling Concrete Construction may deny
my application for employment or if it has already
employed me, that Boling Concrete Construction
may terminate my employment because of information
obtained during its investigation or confirmation,
or both, of my responses made on my employment
application. Upon the termination of my employment
with Boling Concrete Construction, regardless
of when, how, or why my employment ends, and
regardless of whether Boling Concrete Construction
or I terminate my employment, I authorize Boling
Concrete Construction to release information
about my employment history with Boling Concrete
Construction and release Boling Concrete Construction
and all of its agents from any liability for
the disclosure of information about my employment
history to either governmental agencies or employers
to whom I have applied for a job, or both.
I certify that I have given true and complete
information in response to each category of information
requested. I have also read, understood, and
accepted the conditions of employment stated
in this application. I further authorize the
release of information as stated above. I recognize
Boling Concrete Construction's right either
to revoke any employment offer or to terminate
my employment if it ever finds any of my responses
written on this application either to falsify
or to omit, or both, any information. |
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Yes
No |
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