All statements made by applicants for employment on this application form will be checked for accuracy.
We offer equal employment opportunities to all persons without discrimination on the basis of race, color, religion, age, sex, national origin, citizenship
status, physical or mental disability, or past, present, or future service in the Uniformed Services of the U.S. or any other legally protected status. The use
of this form does not mean there are positions open and does not obligate us in any way.
NOTE: ALL FIELDS ARE REQUIRED - INCOMPLETE FORMS WILL NOT BE CONSIDERED
Present Address:
(Please include city, statr and zip code)
Contact in case of emergency:
(Please give name and phone number)
If at present address less than one year, please give previous address:
Yes
No
Are you at least 18 years of age?
(Employment is subject to verification of minimum legal age)
Yes
No
Can you produce documented proof of your identity and eligibility for employment in the United States?
How soon could you report to work?
Temporary
Full Time
Part Time
Type of employment desired:
What days and hours are you available to work?
EDUCATION (Please choose your highest level of education)
Diploma
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
High School
Trade or Technical
College
Vocational Degree
Professional Certification
Yes
No
Have you ever applied for a job with us before?
Have you ever worked for us before?
Yes
No
Employee Referral
Former Employee
Newspaper Ad
Online
How did you come to apply?
If yes, state reason and date:
Yes
No
Have you ever been bonded?
Yes
No
Ever been refused a bond?
Yes
No
Have you ever been convicted of a violation of the law except a minor traffic violation?
If yes, state date, court, and place where offense occurred:
(A conviction will not necessarily disqualify you from employment)
Yes
No
Have you ever been discharged or requested to resign from a position?
Yes
No
Yes
No
If yes, may we contact your present employer?
Yes
No
Have you ever held a position of trust (handling money or confidential material)?
Yes
No
Do you have any reason to believe that you would have difficulty meeting this company's work schedule?
1. Name and Address of Most Recent Employer:
Immediate Supervisors Name and Position:
May we contact this employer?
2. Name and Address of Most Recent Employer:
Immediate Supervisors Name and Position:
May we contact this employer?
3. Name and Address of Most Recent Employer:
Immediate Supervisors Name and Position:
May we contact this employer?
Yes
No
Yes
No
No
Yes
Please provide any additional information such as special skills, training, experience, equipment operation or any other qualifications:
REFERENCES
Please do not list relatives or former employers.
Job Applicant's Agreement and Certification:
I certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be
false in any way, it shall be considered sufficient cause for denial of employment or discharge. I authorize the use of information in this
application for verification and I authorize past employers, references, and any other persons to answer all questions concerning my
ability, reputation, and previous employment record.
I understand that nothing contained in this employment application or in the granting of an interview is an employment contract between
the company and myself and providing the company with this application is not a guarantee of employment or any benefits. If an
employment relationship is established, I understand that I have the right to terminate my employment at any time and the company has
the same right.
If I am offered employment, I agree to submit to a drug test at any time during my employment. I understand that Shen-Valley Masonry,
Inc. will not tolerate drug or alcohol use at any time.
Policies and rules of the company may be revised at any time and if employed, I understand that I will be expected to adhere to all
company rules and regulations.
This application will be on file for 60 days from the date submitted.
I Agree and understand the Terms and Conditions
Please be reminded that once we receive your application and review it, if we have an opening that we feel you qualify for, we will
contact you. Thank you for your submittal.
The Team at Richard B. Souder Masonry, Inc.
