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Job Application Form

Applicant Information

Full Legal Name*

Address*

Phone*

Email*

Applied Position*

Desired Start Date*

Month

Day

Year

Desired Hourly Rate/Salary*

Employment Type*

Full-Time

Part-Time

Seasonal

Availability

Are you available to work overtime when needed?*

Yes

No

Are you available to work weekends when needed?*

Yes

No

Earliest time you can start work:*

Time

:HoursMinutes

Days/Hours with restrictions:*

Construction and Work Experience

Years of construction experience:*

Years of concrete experience:*

Previous construction employer(s):

Type of work performed:

Other relevant experience/skills:

Check all equipment you have experience operating:

Excavator

Skid Steer

Loader

Dozer

Dump Truck

Grader

Concrete Saw

Power Trowel

Laser Screed

Concrete Pump

Compaction Equipment

Other

Skills and Training

Check any skills that you have experience in:

Formwork

Rebar

Foundations

Walls & Piers

Slabs

Site Concrete

Concrete Finishing

Demolition

Rigging/Signal Person

Hand/Power Tools

General Labor

Certifications/Licenses (list type and expiration date if applicable):

Education

Highest level completed:*

GED

High School

College

Trade School

None

School Name:

Field of Study/Training

Graduation year:

Employment History

List your three most recent employers, beginning with the most recent:

1.

Employer\Location:

Position/Duties:

Dates worked:

Supervisor/Phone:

Reason for leaving:

2.

Employer\Location:

Position/Duties:

Dates worked:

Supervisor/Phone:

Reason for leaving:

3.

Employer\Location:

Position/Duties:

Dates worked:

Supervisor/Phone:

Reason for leaving:

References

Please provide two professional references who are not relatives:*

Emergency Contact

Name:*

Relationship*

Phone*

Alternate Phone

Attachments

Resume

Cover Letter

Applicant Certification & Authorization

I certify by typing my name below that the information provided in this application is true and complete to the best of my knowledge. I understand that providing false, misleading, or incomplete information may result in disqualification from employment or termination if discovered after employment. I authorize Cass Concrete Services LLC to verify the information provided in this application and to contact the employers and references listed above, as permitted by law. I understand that employment is subject to applicable company policies and requirements.

Applicant Name:*

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Job Application Form

Applicant Information

Availability

Construction and Work Experience

Skills and Training

Education

Employment History

1.

2.

3.

References

Emergency Contact

Attachments

Applicant Certification & Authorization