Employment Application - Mar-Allen Concrete Products Inc.

Application for Employment - Mar-Allen

Mar-Allen Concrete is an Equal Opportunity Employer and considers all applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, citizenship status, genetic information, veteran status, or any other protected characteristic under applicable law.

Position(s) Applied For

How Did You Learn About Us?

Last Name

First Name

Middle Name

Number

Street

City

State

Zip Code

Telephone Number(s)

Social Security Number (Voluntary)

Best Time to Contact You

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

Yes

Have you ever filed an application with us before?

Yes

Date Previously Applied

Have you ever been employed with us before?

Yes

Dates of Previous Employment

Do any friends or relatives (other than spouse) work here?

Yes

Friend or Relatives Names

Are you currently employed?

Yes

May we contact your current employer?

Yes

Are you prevented from lawfully becoming employed because of Visa or Immigration Status?

Yes

Can you provide proof of citizenship or immigration status upon employment?

Yes

Are you currently on lay-off status or subject to recall?

Yes

Can you travel if a job requires it?

Yes

Date Available for Work

Desired Salary Range

Are You Available to Work? (select all that apply)

Full-Time

Part-Time

Temporary

If Full Time, Which Shift(s)

Shift 1

Shift 2

Shift 3

If Part-Time, Which Hours?

Mornings

Afternoons

Evenings

If Temporary: Start Date

If Temporary: End Date

EDUCATION

Name and Address of Elementary School

Course of Study

Years Completed

Diploma / Degree

Name and Address of High School

Course of Study

Years Completed

Diploma / Degree

Undergraduate College

Course of Study

Years Completed

Diploma / Degree

Graduate Professional

Course of Study

Years Completed

Diploma / Degree

Other (Specify)

Course of Study

Years Completed

Diploma / Degree

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

Describe any job-related training received in the United States military.

Employment Experience - List Most Current Job First

Employer

Work Performed

From:

To:

Starting Rate/Salary

Final Rate/Salary

Address

Phone

Job Title

Supervisor

Reason for Leaving

Employer

Work Performed

From:

To:

Starting Rate/Salary

Final Rate/Salary

Address

Phone

Job Title

Supervisor

Reason for Leaving

Employer

Work Performed

From:

To:

Starting Rate/Salary

Final Rate/Salary

Address

Phone

Job Title

Supervisor

Reason for Leaving

Employer

Work Performed

From:

To:

Starting Rate/Salary

Final Rate/Salary

Address

Phone

Job Title

Supervisor

Reason for Leaving

Employer

Work Performed

From:

To:

Starting Rate/Salary

Final Rate/Salary

Address

Phone

Job Title

Supervisor

Reason for Leaving

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

ADDITIONAL INFORMATION

Other Qualifications: Summarize special job-related skills and qualifications.

Any additional information helpful to your application.

DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING

Can you perform the essential functions of this job, with or without reasonable accommodation?

Yes

REFERENCES

Reference 1: Name

Reference 1: Phone

Reference 1: Address

Reference 2: Name

Reference 2: Phone

Reference 2: Address

Reference 3: Name

Reference 3: Phone

Reference 3: Address

I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as 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.

Type Your Full Name as Signature

Date