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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