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INFRASTRUCTURE REPAIR SERVICE EMPLOYMENT APPLICATION
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Name
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First
Last
Email
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Phone
Best Time to Contact You at Home
If under the age of 18, can you provide proof of your eligibility to work?
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No
Have you ever filed an employment application with us?
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Yes
No
Are any of your friends or relatives employed by us?
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Yes
No
May we contact your current employer?
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Yes
No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (proof of citizenship or immigration status will be required upon employment).
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No
Desired Hourly Wage
How often?
Full Time
Part Time
Temporary
Are you currently on "lay off" or subject to recall?
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Can you travel if the job requires it?
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No
Highest Level of Education
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Describe any specialized training, apprenticeship, skills, and/or extra-curricular activities.
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Describe any job related training received in the United States military.
Experience
Employer
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Employer Phone
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Job Title
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Supervisor
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Reason for Leaving
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Date Started, Date Ended
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Salary/Hourly Wage (start)
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Salary/Hourly Wage (end)
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Description of Work Performe
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Employment #2 Information
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Employment #3 Information
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Resume Upload (optional)
Accepted file types: doc, docx, pdf, png, Max. file size: 64 MB.
Other
List professional, trade, business, or civic activites and offices held (you may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status).
Summarize special job-related skills and qualifications acquired from employment or other experience.
Specialized Skills
PC/Mac
Spreadsheet
Word Processing
Shorthand
WPM
State any additional information you feel may be helpful to us in considering your application.
References (list name, address, phone number, and your relation to the party)
Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation? (do not answer this question unless you have been informed about the requirements of the job for which you are applying).
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Yes
No
I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Digital Signature
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Date of Application
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