Employment Apply Online Apply Online Position(s) Applied For: * Date: * Name: * Email: * Address: * Phone Number: * Date of Birth: * Referred By: * Are you over 18 years old? * Yes No Are you legally eligible for employment in this country? * Yes No Have you ever been employed by A&A Construction & Utilities, Inc.? * Yes No If so: Date From: * Date To: * Pay Rate: * Position: * Employment Desired Date you can start: * Salary/Wage desired: * Are you currently employed? * Yes No If currently employed, can we contact your current employer? * Yes No How many hours can you work per week? * Can you work nights? * Yes No Can you work weekends? * Yes No Driving History Do you have a driver’s license? * Yes No What is your means of transportation to work? * Is your license currently suspended or revoked? * Yes No Driver’s License Number: * State of Issue: * Expiration Date: * Do you have a commercial driver’s license (CDL)? * Yes No If yes, what CDL class? * Endorsements: * Have you had any accidents in the past three years? * Yes No If yes, how many? * Have you had any moving violations during the past three years? * Yes No If yes, how many? * Have you ever been denied a license, permit or privilege to operate a motor vehicle? * Yes No Have you ever had a license, permit or privilege suspended or revoked? * Yes No Have you operated a commercial vehicle in excess of one year? * Yes No Have you ever been convicted of a felony? * Yes No If so, explain (conviction does not deny you employment): * Please list any equipment you have operated: * Education High School: * City/State: * College: * City/State: * Other: * City/State: * References Please list three personal references other than relatives or previous employers: Name: * Address: * Business: * Phone: * Name: * Address: * Business: * Phone: * Name: * Address: * Business: * Phone: * Employment History List your last four employers, starting with your current or most recent, including military service. May we contact your former employers? * Yes No Employer #1 From: * To: * Employer Name: * Job Title: * Street Address: * City, State, Zip: * Phone: * Email * Direct Supervisor: * Reason for Leaving: * Hourly Rate/Salary: Start: * End: * Employer #2 From: * To: * Employer Name: * Job Title: * Street Address: * City, State, Zip: * Phone: * Email: * Direct Supervisor: * Reason for Leaving: * Hourly Rate/Salary: Start: * End: * Employer #3 From: * To: * Employer Name: * Job Title: * Street Address: * City, State, Zip: * Phone: * Email: * Direct Supervisor: * Reason for Leaving: * Hourly Rate/Salary: Start: * End: * Employer #4 From: * To: * Employer Name: * Job Title: * Street Address: * City, State, Zip: * Phone: * Email: * Direct Supervisor: * Reason for Leaving: * Hourly Rate/Salary: Start: * End: * Additional You may upload your resume below File Upload Drop a file here or click to upload Choose File Maximum upload size: 30.72MB Authorization "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA} and/or relevant federal and state laws." *By signing below, you "CERTIFY" that the above information is correct. Signature Clear reCAPTCHA Submit Δ
