Name: |
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Date |
Wednesday, December 31, 1969 |
Address |
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Social Security No: |
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Phone Number: |
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Position Applying For: |
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Desired Salary: |
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| Birthdate (DD/MM)
(do not include year) |
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How did you hear about this position? |
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Do you have friends or relatives working for Reitter
Stucco? |
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If yes, who? |
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Have you ever been employed by Reitter Stucco? |
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If yes, when? |
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Are you at least 18 years of age? |
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If not, can you furnish a work permit? |
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Are you prevented from becoming lawfully employed
in this country because of visa or immigration status? |
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Are you on layoff and subject to recall? |
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Are you physically and mentally capable of performing
the essential duties of the position for which you are applying? |
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Do you have reliable transportation to work? |
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Have you been convicted of a crime, other than a
minor traffic violation within the last seven years? |
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If yes, please describe: |
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(Note: you will not be
automatically excluded from consideration if you have been convicted
of a crime) |
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| Education |
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| School |
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Course of Study |
Did you Graduate? |
| High School |
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| Vocational School |
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| College |
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| Graduate |
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| Other Special Study or Research: |
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| List any special skills, crafts, or abilities you have that would help
you in this position: |
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| List any equipment you can operate: |
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| Military |
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| Have you ever been in the armed forces? |
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| Branch |
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Highest Rank |
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| Active Dates |
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| Military duties related to this position: |
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| Were you discharged for any reason other than dishonorable? |
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| Work Experience |
List previous employment experience beginning
with the most RECENT employer. Go back at least 5 years
or more if space allows. Please indicate if you worked under a different
name. |
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| Company Name: |
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State |
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Supervisor |
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To |
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| Salary Start |
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End |
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| Duties |
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| Reason for Leaving |
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| May we contact this employer? |
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| Company Name: |
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State |
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| Position |
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Supervisor |
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To |
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End |
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| Duties |
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| Reason for Leaving |
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| May we contact this employer? |
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| Company Name: |
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State |
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| Position |
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Supervisor |
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To |
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End |
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| Duties |
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| Reason for Leaving |
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| May we contact this employer? |
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| Company Name: |
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State |
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| Position |
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Supervisor |
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To |
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End |
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| Duties |
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| Reason for Leaving |
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| May we contact this employer? |
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| Company Name: |
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State |
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| Position |
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Supervisor |
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To |
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End |
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| Duties |
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| May we contact this employer? |
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| Company Name: |
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State |
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| Position |
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Supervisor |
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To |
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End |
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| Duties |
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| Reason for Leaving |
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| May we contact this employer? |
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| References |
Give the names of three people, not related
to you, whom you have known at least one year. |
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| Name |
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Phone Number |
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State |
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| Time Known |
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| Name |
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Phone Number |
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| Address |
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State |
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| Time Known |
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| Name |
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Phone Number |
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| Time Known |
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| Do you have a valid driver's license? |
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License Number: |
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| Do you possess a commercial driver's license? |
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If not, are you willing to obtain a CDL? |
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| Do you know basic math (division or fractions)? |
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Are you able to work above ground level on scaffolding? |
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| Can you work out of town for periods of up to 3 weeks? |
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| Do you have construction experience? |
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If so, length of experience |
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| Type of experience |
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| Can you lift 95 pounds on a regular basis? |
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| Are you a certified forklift driver? |
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If not, are you willing to obtain certification? |
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Applicant's
Certification and Agreement |
Please read this statement
carefully and enter your initials to sign. |
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I understand and agree that, if I am employed by Reitter
Stucco and Supply, my employment is at-will and can be terminated, with
or without cause or notice at any time, at the option of either Reitter
Stucco and Supply, or myself. I understand that no representative of
Reitter Stucco and Supply has authority to enter into any agreement
of employment for any specified period of time or to make agreement
with me contrary to the foregoing, except that an officer of Reitter
stucco and Supply may do so in writing.
I further agree to take any lawful medical examination required by
Reitter Stucco and Supply upon receiving a conditional offer of employment
by Reitter Stucco and Supply or, after I am hired, as a condition of
my continuing employment. I agree that my refusal to take any such lawful
examination may be cause for termination of employment. I further understand
that Reitter Stucco and Supply will not hire any applicant who tests
positive or refuses to consent to pre-employment drug testing. Any applicant
who fails the drug screen may be required to wait (90) ninety days from
the date the offer of employment was withdrawn to reapply for employment.
I further understand an employee who tests positive for illegal drugs
or alcohol usage during working hours or who refuses to cooperate to
drug and alcohol testing is subject to discharge.
I authorize investigation of my credit, driving, criminal, education,
and employment history as required by Reitter Stucco and Supply as a
condition of my being hired, or if I am hired, as a condition of my
continued employment. I relieve all persons or companies participating
in any lawful investigation from any liability.
I also agree to take any lawful honesty detection examination and I
release all persons or companies conducting such examination from liability.
I certify that the facts contained in this application and any accompanying
materials are true and complete to the best of my knowledge and I understand
that, if I become employed, any false information I may have provided
on the application or accompanying materials shall be grounds for dismissal.
I also understand that I am required to abide by rules and regulations
of Reitter Stucco and Supply.
An applicant applying for a position in the field may be required to
complete and apprenticeship-training program. The length of this program
is directly related to your prior knowledge and experience of your trade. |
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Please enter your initials to
agree to these terms. |
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Thank you for your interest in our company! |
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