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Employee Application

EMPLOYMENT APPLICATION

(Please print clearly)


Full Name: _______________________________________ Alias if applicable: ____________________

Address: _____________________________________ City: ___________ State:_______ Zip:_________

Phone: _______________ Position Applied For: _________________ Social Security No: ______________

Driver’s License #:_______________________ License Class: __________ Are you insurable _________

Are you a citizen of the United States? _________ If not do you have work papers? ___________________

Are you related to any of our employees? _________ Have you been convicted of a felony? ____________


EDUCATION


High School: _________________________ Did you graduate? _____ What Year did you graduate? ______

Bus/Trade: _________________________ Have you ever been in the military? _____________________


PREVIOUS EMPLOYMENT (Start with most recent)


Company: __________________________________ Address: _____________________________________

Supervisor: _____________________ Position Held: ____________________ Ending Wage: _____________

Dates of Employment: From ______________ To ____________ Reason for leaving: __________________

Summarize your special skills: _______________________________________________________________


Company: __________________________________ Address: _____________________________________

Supervisor: _____________________ Position Held: ____________________ Ending Wage: _____________

Dates of Employment: From ______________ To ____________ Reason for leaving: __________________

Summarize your special skills: _______________________________________________________________


REFERENCES


Name: ______________________________Address: _____________________ Phone: ________________

Name: ______________________________Address: _____________________Phone: _________________

Name: ______________________________Address: _____________________ Phone: _________________


Applicant Note: This application is intended for the use in evaluating your qualifications for employment. This is not an employment contract. Please answer all questions completely and accurately. False or misleading information during the interview or on this form are grounds for terminating the application process or, if discovered after employment, grounds for immediate termination. At the discretion of the management a drug screening could occur. Davis Paving & Sealcoating, Inc. is an equal opportunity employer.


Signature: ___________________________________________________ Date: _____________________

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