Employment – Construction Collaborative

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Position(s) Applied For*

How did you hear about us?*

Name*

Last First Middle

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Best time to contact you at home is:*

:

If you are under 18 years of age, can you provide required proof of your eligibility to work?*

Yes
No

Have you ever filed an application with us before?*

Yes
No

Give date

Have you ever been employed with us before?*

Yes
No

Give dates

Do any of your friends or relatives, other than a spouse, work here?*

Yes
No

State name, relationship and location

Are you currently employed?*

Yes
No

May we contact your present employer?*

Yes
No

Are you prevented from lawfully becoming employed in this country because of visa or immigration status?*

Yes
No

Proof of citizenship or immigration status will be required upon employment.

Date available for work*

What is your desired salary range?*

Are you available to work:

Full Time

Please indicate

First Shift
Second Shift
Third Shift

Part Time

Please indicate

Mornings
Afternoons
Evenings

Temporary

Please indicate dates available

From To

Are you currently on “lay off” status and subject to recall?*

Yes
No

Can you travel if a job requires it?*

Yes
No

Education

High School

Name of School	Address of School	Course of Study	Years Completed	Diploma/Degree

Undergraduate College

Name of School	Address of School	Course of Study	Years Completed	Diploma/Degree

Graduate/Professional

Name of School	Address of School	Course of Study	Years Completed	Diploma/Degree

Other (specify)

Name of School	Address of School	Course of Study	Years Completed	Diploma/Degree

Work Experience

Start with you present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone Number(s)

First Last

Starting/Present Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

May we contact?

Yes
No

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone Number(s)

First Last

Starting/Present Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

May we contact?

Yes
No

Employer

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Telephone Number(s)

First Last

Starting/Present Job Title

Supervisor

Reason for Leaving

Dates Employed

From To

Hourly Rate/Salary

Starting Final

Work Performed

May we contact?

Yes
No

Include explanation of any gaps in employment, if necessary:

Describe any specialized training, apprenticeship, skills, and extra-curricular activities:

List professional, trade, business or civic activities and offices held:

You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

Additional Information

Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience.

Specialized Skills

(Skills/Equipment Operated)

Terminal
Spreadsheet
PC/Mac
Word Processing

WPM

Typewriter

WPM

Shorthand

Production Mobile Machinery (list)

Other (list)

State any additional information you feel may be helpful to us in considering your application:

Are you capable of performing this job?

Note to applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of activities involved in such a job or occupation has been given.

Yes
No

Personal/Professional References

Do not include family members or past supervisors.

Personal/Professional References

Name	Phone Number	Best Time to Call	Occupation

Applicant's Statement

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment 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. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

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.

By typing your name in the field below, you are signing this statement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this statement.

Name*

Signature of Applicant Date

Application for Employment

Education

Work Experience

Additional Information

Specialized Skills

Personal/Professional References

Applicant's Statement