Application Form - DL Cohen Construction Co

JOB APPLICATION

Equal Employment Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, physical or mental disability, genetic information, or any other condition protected by law or regulation. It is our intention to provide equal employment opportunities to all qualified applicants and to base selection decisions on job-related factors.

Please answer each question completely and accurately. This application will not be processed until you have answered all questions. Use blank paper if you do not have enough space on this application. Please print or complete legibly, except for your signature on the back of the application. As you read and answer the following questions, please be aware that none of the questions imply unlawful or discriminatory preferences based on information unrelated to work.

Position:

Referred by:

Today's date:

Are you looking for full-time employment?

Part-Time

Temporary

When could I start working?

Email address

Last name

First name

Middle name

Telephone

Current address

Apartamento/Unidad #

City

State

Zip code

Are you over 18 years old?

Yes

(If you are hired, you may be asked to provide proof of age)

If we employ you, you must provide proof that you are authorized to work in the United States of America (U.S.A.).

Have you applied to this company before?

Yes

If so, when?

Have you worked at this company before?

Yes

If so, when?

If you're hired, do you plan to participate in any other business or get another job outside of our company?

Yes

If yes, please give details

For driver jobs only: Do you have a valid driver's license?

Yes

Driver's license number

License class

In which state (U.S.A.) did you obtain your license?

Have you had your driver's license suspended or revoked in the last 3 years?

Yes

If yes, please give details:

Please indicate any professional, business, industry-related, or civic activities and any official positions held.(Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability, genetic information or other protected status.)

Please indicate any professional, business, industry-related, or civic activities and any official positions held.

High school or GED:

Address:

Did you graduate?

Yes

Diploma/Degree/Certificate:

What skills or additional training do you have that relate to the job for which your applying?

What machines or equipment can you operate that relate to the job for which you are applying?

University:

Address:

Did you graduate?

Yes

Diploma/Degree/Certificate:

What skills or additional training do you have that relate to the job for which your applying?

What machines or equipment can you operate that relate to the job for which you are applying?

Other:

Address:

Did you graduate?

Yes

Diploma/Degree/Certificate:

What skills or additional training do you have that relate to the job for which your applying?

What machines or equipment can you operate that relate to the job for which you are applying?

Please list the names of your employers in consecutive order; specify your current or most recent employment first. Include all periods, including military service and any periods of unemployment. If you are employed or self-employed, give the name of the company and provide business references. Note: The job offer may be contingent upon receiving acceptable references from current and previous employers.

COMPANY NAME

POSITION AND JOB DESCRIPTION

ADDRESS

EMPLOYMENT PERIOD FROM (MONTH/YEAR)

UNTIL (MONTH/YEAR)

CITY, STATE, ZIP CODE

REASON FOR LEAVING:

SUPERVISOR(S)

PHONE

COMPANY NAME

POSITION AND JOB DESCRIPTION

ADDRESS

EMPLOYMENT PERIOD FROM (MONTH/YEAR)

UNTIL (MONTH/YEAR)

CITY, STATE, ZIP CODE

REASON FOR LEAVING:

SUPERVISOR(S)

PHONE

COMPANY NAME

POSITION AND JOB DESCRIPTION

ADDRESS

EMPLOYMENT PERIOD FROM (MONTH/YEAR)

UNTIL (MONTH/YEAR)

CITY, STATE, ZIP CODE

REASON FOR LEAVING:

SUPERVISOR(S)

PHONE

Have you worked or attended school under other names?

Yes

If yes, please provide names:

Are you currently employed?

Yes

If so, who do you suggest we contact?

Have you ever been fired from a job or asked to resign?

Yes

If yes, please explain

Provide three references, not from family members or previous employers.

Name	Address	Phone

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all information provided in this job application is true and complete. I understand that any false information or omissions may disqualify me for this job and could lead to my termination if later discovered.

I UNDERSTAND THAT THIS APPLICATION, ORAL STATEMENTS BY MANAGERS, OR SUBSEQUENT EMPLOYMENT DO NOT CONSTITUTE AN EXPRESS OR IMPLIED EMPLOYMENT CONTRACT, NOR DOES IT GUARANTEE EMPLOYMENT FOR A CERTAIN PERIOD. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE POWER TO ENTER INTO AN EMPLOYMENT CONTRACT FOR A CERTAIN PERIOD, AND SUCH CONTRACT MUST BE IN WRITING AND SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF I AM HIRED, I UNDERSTAND THAT IT IS AT THE WILL OF THE EMPLOYER AND THE EMPLOYMENT RELATIONSHIP MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON OR PRIOR NOTICE.

I have read and understood these statements and, by signing them, I consent to them.

Signature:

Date

This application for employment will remain active for a limited time. Ask the organization’s representative for details.