Personal Information:Full Name: *Email Address: *Phone: *Street Address: *Apartment, suite, etc:City:State/ProvinceZIP / Postal CodeDate of Birth *Social Security NumberPosistion Applying for:Asphalt CrewPipe CrewGrading CrewGeneral LaborRate of Pay Expected:USDHighest Level of Education Completed: *N/AHigh SchoolCollegeGraduate SchoolTrade, Bus., Night, or Corres.Name and Address of School:Other Skills:List any job related skills or qualifications that support your application.Have you had prior educational experience related to the job? *Y/N?YesNoIf yes, please describe:Are you a veteran of the U.S. Military Service? *Y/N?YesNoIf yes, please list the branch you served in and your date of discharge:What is your race/ethnic origin? *SelectWhite (Not of Hispanic Origin)Black (Not of Hispanic Origin)HispanicAmerican IndianAlaskan NativeOther/UnlistedWhat is your gender? *M/F?MaleFemaleEmployment Experience:Please list your past 4 most recent jobs below, starting with the most recent.Job #1Employer: *Employment Start Date: *Employment End Date: *Job Title / Work Performed: *Starting Rate: *USDEnding Rate: *USDSupervisor Name: *Supervisor Contact #: *Reason for leaving? *Job #2Employer: *Employment Start Date: *Employment End Date: *Job Title / Work Performed: *Starting Rate: *USDEnding Rate: *USDSupervisor Name: *Supervisor Contact #: *Reason for leaving? *Job #3Employer: *Employment Start Date: *Employment End Date: *Job Title / Work Performed: *Starting Rate: *USDEnding Rate: *USDSupervisor Name: *Supervisor Contact #: *Reason for leaving? *Job #4Employer: *Employment Start Date: *Employment End Date: *Job Title / Work Performed: *Starting Rate: *USDEnding Rate: *USDSupervisor Name: *Supervisor Contact #: *Reason for leaving? *Have you ever been dismissed or forced to resign from any past job? *Have you ever been dismissed or forced to resign from any past job?YesNoIf yes, please explain:Emergency ContactIN CASE OF EMERGENCY, NOTIFY:NamePhoneRelationshipStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeMiscellaneous InfoDo you have any friends or relatives who work here? *Y/N?YesNoNameRelationshipNameRelationshipAre you now employed? *Y/N?YesNoAre you on a layoff? *Y/N?YesNoAre you subject to recall? *Y/N?YesNoMay we contact your present Employer? *Y/N?YesNoPrevious Employer? *Y/N?YesNoPlease identify any reasons for not contacting previous employers:Character References:NameAddressPhoneOccupationNameAddressPhoneOccupationNameAddressPhoneOccupationList any other info or remarks that you wish considered as a part of your application:Have filed an application here before? *Y/N?YesNoIf yes, please provide a date(s):Have you ever been employed here before? *Y/N?YesNoIf yes, please provide a date(s):Applicant's StatementI certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all matters contained in this application and hereby give the Employer permission to contact schools, previous employers, references, and others, and hereby release the Employer from any liability as a result of such contact. I understand that misrepresentation, omissions of facts or incomplete information requested in this application may remove me from further consideration for employment. In addition, if employed, any misrepresentations or omissions of facts called for in this application will be cause for dismissal at any time without any previous notice. Applicants accepted for employment should clearly understand that while we make every effort to provide steady, continuous work, we have no employment contracts, and we cannot guarantee the permanence of any position. Job tenure can be affected by many factors including business/economic conditions, changes in laws or employee policies, conformity to our work rules, job performance, etc. And of course, an employee may elect to leave on their own accord to seek other jobs. I understand that my employment with the Employer is for no specific term and may be terminated by me or the Employer with or without notice or cause at any time. I further understand that no oral promise, employer policy, custom, business practice or other procedure (including the Employer's Personnel Handbook or any personnel manuals) constitutes an employment contract or modification of the at-will employment relationship between me and the Employer. The contents of any employee handbook or personnel manuals, as well as other Employer policies and practices, are subject to change or modification by the Employer, solely at its discretion, without notice. I also understand that no supervisor or other official of the Employer (except its Chief Executive Officer, in writing) has the authority to enter into any agreement with me or to make any agreement contrary to the foregoing. We conduct our business with the highest possible degree of safety and efficiency. Because of this, the Employer may require applicants for employment to undergo blood and/or urinalysis screening for drug or alcohol use as part of our pre-placement physical examination. In addition, all employees of the Employer are subject to blood tests or urinalysis screening for drug or alcohol use. This application will remain for ninety (90) days. Any applicant wishing to be considered for employment beyond ninety (90) days should reapply. I agree in advance if there is a workmen's compensation or health claim, I the undersigned agree to an illegal substance and alcohol testing and understand that if I test positive my benefits will be terminated. *Start signing your signature hereYour browser does not support e-Signature field.Release FormI understand that certain reports may be obtained from various institutions to verify the accuracy of the information contained in this employment package. These reports include a history of insurance claims, motor vehicle reports, employment references (including previous drugs and alcohol test results,) and criminal background checks. By applying for employment with Art Walker Construction, Inc., I consent to the above-mentioned reports and hereby release Art Walker Construction, Inc. from any and all liability resulting from such action. I also authorize any party or agency contacted by Art Walker Construction to furnish, unconditionally, the above-mentioned information. *Start signing your signature hereYour browser does not support e-Signature field.Consent *Confirm that the information provided is true and accurate.Resume UploadChoose FileNo file chosenDelete uploaded fileApply