APPLICATION FOR EMPLOYMENT                                                                                 

 An Equal Opportunity Employer                                                                                                                             

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                                                        

PERSONAL INFORMATION

NAME:    

PRESENT ADDRESS:   Please include city, state, and zip code

HOME OR NEAREST PHONE: 

SOCIAL SECURITY NUMBER: 

CONTACT IN CASE OF EMERGENCY:  Please give name and phone number

If at present address less than one year, please give previous address: 

Are you at least 18 years of age?      Yes   No  (Employment is subject to verification of minimum legal age)

Can you produce documented proof of your identity and eligibility for employment in the United States?      Yes      No

Position(s) applied for:

How soon could you report to work? 

Type of employment desired?    Full-Time         Part-Time         Temporary            Rate of pay expected: 

What days and hours are you available to work?     Days:     Hours:  from _am to _pm

EDUCATION

Have you ever applied for a job with us before?  Yes    No           Have you ever worked for us before?    Yes    No

How did you come to apply?    Employee Referral       Former Employee       Newspaper Ad       Recruitment      Walk-In  

Have you ever been bonded?   Yes   No         Ever been refused a bond?    Yes    No      If yes, state reason and date:

Have you ever been convicted of a violation of the law except a minor traffic violation?   Yes     No      If yes, state date, court, and place where offense occurred:   (A conviction will not necessarily disqualify you from employment)

Have you ever been discharged or requested to resign from a position?    Yes    No

Are you employed now?    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    If so, describe: 

Do you have any reason to believe that you would have difficulty meeting this company's work schedule?     Yes        No 

WORK HISTORY

1.  Name and Address of Most Recent Employer:

Telephone Number:            Date Hired:          Date Left:    

 Immediate Supervisors Name and Position: 

Job Title and Duties: 

Starting Pay:        Last Pay:         May we contact this employer?    Yes     No   

Reason for Leaving: 

2.  Name and Address of Former Employer: 

Telephone Number:           Date Hired:          Date Left: 

Immediate Supervisors Name and Position: 

Job Title and Duties: 

Starting Wage:        Last Wage:       May we contact this employer?   Yes    No

Reason for Leaving: 

3.  Name and Address of Former Employer: 

Telephone Number:           Date Hired:           Date Left: 

Immediate Supervisors Name and Position: 

Job Title and Duties: 

Starting Wage:          Last Wage:         May we contact this employer?   Yes     No

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.

Please select one of the following if you have read and understood the above conditions and agree to abide by them:

I understand and agree                     I don't agree 

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 Shen-Valley Masonry