Construction & Excavating, LLC
 
 

Employment Application
 

Personal Information:
Name:
Social Security #:
Address:
City:
State:
Zip Code:
 

Employment Desired:
Position
Start Date
Salary desired
Are you currently employed? Yes No
If so, may we contact your present employer? Yes No
Have you ever applied to this company before? Yes No
Where
 
When
 

Education:
  Name and Location of School Years Attended Did you Graduate? Subject Studied
Grammar School Yes No
High School Yes No
College Yes No
Trade, Business, or Correspondence Yes No
 

General
Subjects of special study/research work or special training skills
 
U.S. Military Service: Rank:
 
Have you ever been convicted of, or guilty or nolo contendre (no contest) to a felony offense? Yes No
( If yes, please explain the date, location, nature of the facts surrounding each conviction)
 

Former Employers
(List the last four employers, starting with the last one first)
Date Name & Address of Employer Salary Position Reason for Leaving
 

References
Give the names of three persons not related to you, whom you have know for at least a year.
Name Phone Number Address Business Years Known
 

Additional Information
If part time desired, which days and times:
Training and/or skills applicable to job desired:
Other Comments:
 

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 pertain ate information they may have, personal or otherwise, and release the company from all liability from 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.
 
I Agree to the Authorization Statement.