ROC 070006 A

ROC 070007 B-01

ROC 077668 R-37R

ROC 077063 C-37

ROC 146634 B


Employment Application

APPLICATION FOR EMPLOYMENT

Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap or veteran status.

Application for Employment

  • PERSONAL

  • EDUCATION

Graduate

College

Business/Trade/Technical

High School

Elementary

 

Membership in Professional or Civic Organizations

(Exclude those which may discuss your race, color religion or national origin)


  • EMPLOYMENT

Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.


1

2

3

4


We may contact the employers listed above unless you indicate those you do not want us to contact.


DO NOT CONTACT


  • MILITARY

The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex or national origin. Federal law also prohibits discrimination based on age and citizenship. The laws of most States also prohibit some or all of the above types of discrimination as well as some additional types such as discrimination based upon ancestry, marital status or physical or mental handicap or disability.


Provide dates you attended school:

If not, employment is subject to verification of age.



  • SIGNATURE

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.


I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employment in the future.


If you decide to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.


  • APPLICATION SUPPLEMENT

Mechanic:

Heavy Equipment:

Trucks:

General Servicing:

Truck Driver: (State Type & Trans.)

10-Wheeler Dump Truck

Bobtail-6 Wheel Dump Truck

 


Drivers License:


MEDICAL HISTORY: have you ever had?


If yes to any of the above, please give details:


OFFICE USE ONLY:


  • APPLICATION SUPPLEMENT

This supplement must be answered completely by all applicants to be considered for employment.

Do you have experience in the following?


Main Water Line Placement

Water Service Placement

Asphalt Paving

Manhole Placement

Conduit - Electrical

Conduit - Communication

Concrete Placement

Concrete Finishing

Compaction Techniques

Compaction Equipment

Carpentry:

Forming Structural

Forming Curbs/Sidewalks

Rough, Frame, Building

Welding:

Gas, Arc, Cutting & Burning


  • APPLICATION SUPPLEMENT FOR OPERATORS

State make and size you have operated in each category.


Equipment:

Backhoe:

Excavator:

Dozer:

Loader:

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