Employment Application

Section I: Personal Data

Your Name


Telephone


Date of Application


Present Address


Social Security Number


Are you at least 18 years of age?
YesNo
Do you have any relatives working here?


Have you ever been convicted of a violation of the law, other than a minor* traffic violation (*minor = a violation such as a parking ticket)
YesNo
If yes, please explain.

Section II: Work Preference

Position Desired


Date Available


Expected Salary


Hours Preferred
Full TimePart TimeTempOther
Previously Applied?
YesNo
Date Previously Applied

Section III: Employment History

List most recent employer first. Account for all time since school, including unemployed periods. Continue on a separate sheet, if necessary.
Dates Employed (From/To)


Employer Name


Position


Address


Supervisor Name


Telephone


May we contact?

Duties of Position


Present or last salary


Reason for leaving

Dates Employed (From/To)


Employer Name


Position


Address


Supervisor Name


Telephone


May we contact?

Duties of Position


Present or last salary


Reason for leaving

Dates Employed (From/To)



Employer Name


Position


Address


Supervisor Name


Telephone


May we contact?

Duties of Position


Present or last salary


Reason for leaving

Dates Employed (From/To)



Employer Name


Position


Address


Supervisor Name


Telephone


May we contact?

Duties of Position


Present or last salary


Reason for leaving

Section IV: Military Experience

Branch of Service


Date of Service


Highest Rank


Military Skills/Training

Section V: Education

High School


Years Completed


Graduated?
YesNo
Degree received/expected


College/Other


Years Completed


Graduated?
YesNo
Degree received/expected

Section VI: Skills/Licenses

(Please check all of the skills that apply):
Typing WPM (Specify below)Ten Key by TouchSwitchboardWord Processing (Specify below)Spreadsheets (Specify below)Other Computer Programs (Specify below)CraneRead Blue PrintsGrid & Ceiling TileConcretePower ToolsMetal Door HangingMetal Stud FramingForm WorkWeldingRough CarpentryFinish CarpentryDrywallTape & FloatBobcat LoaderWood Stud FramingFinish HardwareLaser LevelBack Hoe
Specify Skills/Licenses:


List any other skills that would be relevant to the position for which you are applying:


List any Licenses/Certifications:


In what languages are you fluent?

Section VII: Referral Source

NewspaperTWCWalk-inFriendInternetOther

Section VIII: Release of Information

I certify that all information provided by me on this application is true and complete. I authorize you to request, receive and verify all information given on this application and understand that any misstatement, falsification, or omission of information is grounds for refusal to hire, or, if hired, termination, regardless of when found. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I will release all such parties from all liability from any damages which may result from furnishing such information to you.
I acknowledge that if I am employed, my employment will be at-will and may be terminated with or without cause at any time by my employer or me.
I agree to conform to the rules and regulations of Valot General Contractors LLC, Inc. and also agree that my employment and compensation can be modified or terminated with or without cause, and with or without notice, at any time, at the option of Valot General Contractors LLC, Inc. or myself.

Signature

Date Signature