Basic Information
First Name
Last Name
Email Address
Phone Number
Address (Street, Apt)
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
How long at current address?
Are you authorized to work in the U.S.?
Have you ever been convicted of crime?
If you have been convicted of a crime, please provide an explanation.
Position Desired
Position
Salary Desired
How many hours can you work weekly?
Can you work long hours, if necessary?
Are you willing to travel?
Start Date Available
Education
High School
Did you graduate from HS?
Course of Study for HS
Technical School
Did you graduate from Tech School?
Course of Study
College/University
Did you graduate from College/University?
Course of Study for College
Post Graduate Education
Did you graduate Post Grad?
Course of Study for Post Grad
Other education, training or special skills
Equipment Certifications
Work Experience
Please list all previous employment, beginning with the most recent job held. If you were self-employed, give firm name.
1.
Employer
Phone
Address
Your Job Title
Name of last supervisor
Start Date
End Date
Reason for Leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked for this company.
2.
Employer
Phone
Address
Name of last supervisor
Your job title
Start Date
End Date
Reason for Leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked for this company.
3.
Employer
Phone
Address
Name of last supervisor
Your job title
Start Date
End Date
Reason for Leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked for this company.
References
Please list two professional references. Previous or current supervisors, rather than co-workers, are preferred.
1.
Name
Position/Relationship
Company
Address
Phone
Email
2.
Name
Position/Relationship
Company
Address
Phone
Email
Please list two personal references other than relatives or previous employers.
1.
Name
Position/Relationship
Company
Address
Phone
Email
2.
Name
Position/Relationship
Company
Address
Phone
Email
Employment Application Consent Release
I hereby certify that the Application for Employment was completed by myself and that the facts set forth therein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application. I understand that if employed, falsified statements, misrepresentation or omission of facts called for may result in dismissal.
I hereby give J&L Contracting permission to contact, via e-mail or phone, schools, previous and current employers (unless otherwise indicated), and references listed on Application of Employment. In addition, I release and hold harmless any person, firm or entity that discloses matters in accordance with this authorization, as well as from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information.
I hereby authorize J&L Contracting to perform a driving record and background check in accordance with J&L Contracting policies.
I understand that J&L Contracting has a no-tolerance drug policy and reserves the right to pre-employment testing and that successful passing of such testing is a condition of my employment.
I further understand that my employment with J&L Contracting shall be probationary for a period of ninety (90) days, and after successfully completing my probationary period, my employment relation with J&L Contracting is terminable “at will” for any reason by either party.
Electronic Signature Consent
By selecting the checkbox below, I acknowledge and agree that my action constitutes an electronic signature as defined under the Electronic Signatures in Global and National Commerce Act (E-SIGN) and the Uniform Electronic Transactions Act (UETA) and is legally binding in the same manner as my handwritten signature. I understand that this electronic signature is as legally valid and enforceable as a manual signature.
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