PERSONAL INFORMATION

Please complete all required fields.

EMPLOYMENT DESIRED

Please fill out all applicable fields.

APPLYING FOR A DRIVER POSITION

1. Is your CDL a Class A or B?

a. List any endorsements:

2. Do you have any experience loading and unloading heavy equipment?

3. Have you driven a CDL vehicle with a manual transmission? If yes, how long?

4. Do you have any experience working with a paver?

5. Are you available to work nights?

6. Do you have any points against your license? If yes, please explain:

Education

MILITARY EXPERIENCE

REFERENCES

List three (3) non-relatives who are familiar with your qualifications, work history and ability

EMPLOYMENT EXPERIENCE

Start with your present or last job. List your last four (4) jobs in order. Do not omit any job.

DISCLAIMER & SIGNATURE

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS APPLICATION FOR EMPLOYMENT, PLEASE ASK THEM PRIOR TO SIGNING. *All following fields are required.

I certify that all answers and statements I have made on this application (and resume and other supplemental materials) are true and complete without omissions. I understand that any false information will result in refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character and qualifications. Yes No

If hired, I will be responsible for familiarizing myself with all the rules and regulations of Empire Paving as they presently exist or are later modified. If hired, I understand employment can be terminated, at the discretion of the company or at my option, without notice, at any time, except as specifically set forth in writing in a current individual employment agreement, which I have entered into with the company.
Yes No

I also understand that no representative of Empire Paving has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits or terms and conditions of employment, except as specifically stated in a current written agreement signed by the Owner/General Manager. Yes No

I understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time. Yes No

By signing below, I authorize Empire Paving to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I further authorize Empire Paving to order one or more consumer reports containing financial, driving record, and/or other information about me from a consumer reporting agency. I understand that the consumer report(s) will be requested and used for the purpose of evaluating me for employment, promotions, transfers, and/or retention as an employee.

For security purposes, please enter the characters from the box above:

What's This?