Do you have any physical condition which may limit your ability to perform the particular job for which you are applying?
If yes, describe such condition:
What method of transportation will you use to get to work?
Position(s) applied for:
Rate of pay expected ($ per week):
I am interested in working:
Specify days and hours, if part-time:
Were you previously employed by us?
If yes, when?
List any relatives or friends working for us:
If your application is considered favorably, on what date would you be available for work?
Are there any other experiences, skills or qualifications which you feel would especially fit you for work with our organization?
List current employment first
Employer 1: Company Name, Address & Telephone
Employer 1: Date Started
Employer 1: Date Ended
Employer 1: Position
Employer 1: Starting Salary
Employer 1: Ending Salary
Employer 1: Reason for Leaving
Employer 1: Supervisor Name
Employer 2: Company Name, Address & Telephone
Employer 2: Date Started
Employer 2: Date Ended
Employer 2: Position
Employer 2: Starting Salary
Employer 2: Ending Salary
Employer 2: Reason for Leaving
Employer 2: Supervisor Name
Employer 3: Company Name, Address & Telephone
Employer 3: Date Started
Employer 3: Date Ended
Employer 3: Position
Employer 3: Starting Salary
Employer 3: Ending Salary
Employer 3: Reason for Leaving
Employer 3: Supervisor Name
Employer 4: Company Name, Address & Telephone
Employer 4: Date Started
Employer 4: Date Ended
Employer 4: Position
Employer 4: Starting Salary
Employer 4: Ending Salary
Employer 4: Reason for Leaving
Employer 4: Supervisor Name
May we contact the above employers?
If not, indicate by number which one(s) you do not wish us to contact:
Not former employers or relatives
Reference 1: Name & Occupation
Reference 1: Address
Reference 1: Phone
Reference 2: Name & Occupation
Reference 2: Address
Reference 2: Phone
Reference 3: Name & Occupation
Reference 3: Address
Reference 3: Phone
Reference 4: Name & Occupation
Reference 4: Address
Reference 4: Phone
Additional information you would like to provide to us:
"I authorize Bilbrey Construction, Inc. to obtain my employment and personal references, and to contact the employment and personal references, except as indicated above, upon consideration of employment with Bilbrey Construction, and, if employed by Bilbrey Construction, to provide references on my employment with Bilbrey Construction, Inc. to prospective future employers."
I do not agree
RECORD OF EDUCATION
High School: Name & Location
College/Trade School: Name & Location
College/Trade School: Course of Study & Degree
"I authorize Bilbrey Construction, Inc. to verify the information I provide regarding my education and employment, upon consideration of employment with Bilbrey Construction.”
I do not agree
DRUG & ALCOHOL POLICY
It is Bilbrey Construction, Inc.'s policy to maintain a safe and productive "Drug and Alcohol Free" work place for its employees, subcontractors, and its customers. Drug and alcohol use is highly detrimental to the safety and productivity of employees in the work place.
Prior to employment, but after a conditional job offer has been made to an applicant, Bilbrey Construction will require applicants to first pass a drug/alcohol screening done by an independent testing lab of the employer's choice and at the expense of the employer. A "positive" drug test result for an applicant will result in the withdrawal of the offer of employment.
MILITARY SERVICE RECORD
Were you in the U.S. Armed Forces?
If yes, what branch?
Dates of duty:
Rank at discharge:
List duties in the service, including special training:
Have you taken any training under the GI Bill of Rights?
If yes, what training?
If employed by Bilbrey Construction, Inc., you will be issued an employee Handbook. This Handbook does not create a contract of employment, either express or implied, between Bilbrey Construction, Inc. and the applicant for employment, hours of work, or the providing of benefits. Therefore, Bilbrey Construction, Inc. employees are employees-at-will.
“I attest that the information provided in this application for employment is accurate; and am aware that falsification of any answer on this application will be grounds for my immediate dismissal and may result in denial of workers’ compensation benefits.”
I do not agree