Home
Services
About Us
Projects
Contact
EMPLOYMENT
EMPLOYEE CENTER
WHY CHOOSE ASPHALT?
APPLICATION
CONTACT INFORMATION
Please answer the following questions. If not applicable, please list N/A.
*
Indicates required field
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Social Security Number
*
Date available to start
*
Position Desired
*
SELECT A VALUE
Laborer
Dump Truck Driver
Equipment Operator
Asphalt Paver Operator
DESIRED RATE OF PAY
*
List any craft training or special courses taken:
*
DRIVING INFORMATION
Do you have a Commercial Driver License?
*
SELECT A VALUE
Yes
No
If yes, how long have you had your CDL?
*
Driver License Class (CDL only)
*
SELECT A VALUE
A
B
C
D
N/A
Type of truck/equip you can operate/repair. List years of exp. for each
*
WORK EXPERIENCE
Are you currently employed?
*
SELECT A VALUE
YES
NO
PROVIDE YOUR WORK HISTORY FOR (AT MINIMUM) THE LAST 3 YEARS TO THE PRESENT.
Job Title
*
Company Name
*
Start Date MM/YYYY
*
End Date MM/YYYY
*
Immediate Supervisor
*
Supervisor's Phone Number
*
May We Contact Previous Employer?
*
SELECT A VALUE
YES
NO
Pay Rate
*
Job Description
*
Special Skills, Equipment, and Certifications:
*
Reason for leaving
*
Job Title
*
Company Name
*
Start Date MM/YYYY
*
End Date MM/YYYY
*
Immediate Supervisor
*
Supervisor Phone Number
*
May We Contact Previous Employer?
*
SELECT A VALUE
YES
NO
Pay Rate
*
Job Description
*
Special Skills, Equipment, and Certifications:
*
Reason for Leaving
*
Job Title
*
Company
*
Start Date MM/YYYY
*
End Date MM/YYYY
*
Immediate Supervisor
*
Supervisor Phone Number
*
May We Contact Previous Employer?
*
SELECT A VALUE
YES
NO
Pay Rate
*
Job Description
*
Special Skills, Equipment, and Certifications:
*
Reason for Leaving
*
EDUCATION
HIGH SCHOOL
Name & Location of school
*
Years Attended
*
Did you graduate?
*
SELECT A VALUE
YES
NO
Degree
*
COLLEGE
Name & Location of school
*
Years Attended
*
Did you graduate?
*
SELECT A VALUE
YES
NO
N/A
Degree
*
TRADE, BUSINESS, OR CORRESPONDENCE SCHOOL
Name & Location of school
*
Years Attended
*
Did you graduate?
*
SELECT A VALUE
YES
NO
N/A
Degree
*
REFERENCES
Please list two persons not related to you that we may call/email for reference.
If you don't have a valid email address for your reference, please use "Your First.Last
[email protected]
". Please understand that employers may not be able to contact your reference without a valid email address.
Name
*
First
Last
Phone Number
*
Job Title
*
Email
*
Relationship to you
*
Name
*
First
Last
Phone Number
*
Job Title
*
Email
*
Relationship to you
*
ACCIDENT RECORD
Please list your accident record for the past
5 YEARS.
If not applicable, select "NO" from the dropdown.
Have you had any accident(s) in the last 5 years?
*
SELECT A VALUE
YES
NO
If YES, answer all of the following in the box below:
1. Date of accident
2. Type of accident (example: rear end, head on)
3. Were there fatalities
4. Were there injuries
Include ALL accidents in the last 5 YEARS.
If you answered NO type "N/A" in the box below.
Comment
*
TRAFFIC CONVICTIONS
Please list any traffic convictions/forfeitures (other than parking violations) for the past
5 years.
If not applicable, select "no".
Have you had any traffic convictions/forfeitures in the last 5 years?
*
SELECT A VALUE
YES
NO
If YES, answer all of the following in the box below:
1. Date of traffic conviction/forfeiture
2. Location
3. Charge
4. Penalty/Fine
Include ALL traffic convictions/forfeitures in the last 5 YEARS.
If you answered NO, type "N/A" in the box below
Comment
*
AUTHORIZATION
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.
I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment"
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.
Authorization Statement Acknowledgement
*
I have read the authorization statement
Electronic Signature (Type full name here)
*
Date (MM/DD/YYYY)
*
If you need help accessing this page, please
contact us
.
We are an equal opportunity employer. Qualified minorities, women, veterans and individuals with disabilities are encouraged to apply.
If you want to view the EEO is the Law poster, please choose your language:
English
-
Spanish
Submit
Home
Services
About Us
Projects
Contact
EMPLOYMENT
EMPLOYEE CENTER
WHY CHOOSE ASPHALT?