Employment Opportunities Employment Application Interested in working for us? Please fill out the Employment Application below. Applicant InformationApplicants are considered for all positions. During employment employees are treated without regard to race, creed, color, religion, sex, national origin, age, marital, veteran or citizenship status, physical or mental handicap or disability. As employers/government contractors, we comply with government regulations and affirmative action responsibilities. Please complete the Applicant Data Record in order for us to comply with government recordkeeping, reporting and other requirements. We appreciate your cooperation. This data is for periodic government reporting and will be kept in a Confidential File separate from the application for employment.We are an equal opportunity employer. Race, color, religion, age, sex, and national origin are not factors in employment, promotion, and compensation.Name:* First Middle Last Address:* Street Address City State ZIP Home Phone:*Work Phone:*Email:* Referred By:Are you over 18? Yes No Are you a citizen of the United States? Yes No If no, are you authorized to work in the U.S.? Yes No Have you ever been convicted of a felony? Yes No If yes, please describe:Position Applying for:Date you can start:Are you employed now? Yes No If so, may we contact your employer? Yes No Salary desired:Applying for full or part time work? Full Part Have you applied for employment here before? Yes No Have you ever been employed here? Yes No If so, when?:Referral Source Advertisement Friend Relative Walk-In Employment Affirmative Action SurveyCheck One Male Female Check One of the Following White Black Asian/Pacific Islander Hispanic American Indian / Alaskan Native Check all that Apply Vietnam Veteran Disabled Veteran Disabled EducationHigh School Name:Address:Dates Attended: From To Did you graduate? Yes No College Name:Address:Dates Attended: From To Did you graduate? Yes No Other Educational Institution:Address:Dates Attended: From To Did you graduate? Yes No Other Training / Education:List any experience you have had in construction work:List any skills you have that may be beneficial to the job (i.e. welding):Do you have any physical conditions that may limit your ability to perform this job? If so, explain:Have you ever had a Workman's Compensation claim? If so, explain:ReferencesPlease list three professional references.Full Name:Company:Years Known:Phone:Address:Full Name:Company:Years Known:Phone:Address:Full Name:Company:Years Known:Phone:Address:Previous EmploymentCompany:Phone:Address:Supervisor:Job Title:Salary: Starting Salary Ending Salary Specific Duties:Dates Employed: From To Reason for Leaving:Company:Phone:Address:Supervisor:Job Title:Salary: Starting Salary Ending Salary Specific Duties:Dates Employed: From To Reason for Leaving:Company:Phone:Address:Supervisor:Job Title:Salary: Starting Salary Ending Salary Specific Duties:Dates Employed: From To Reason for Leaving:AcknowledgementPLEASE READ BEFORE SIGNING I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing which, if disclosed, would affect this application unfavorably. If should be noted that if any misrepresentation has been made on this application, any offer of employment may be withdrawn or your employment terminated without any obligation or liability to Harshman Construction other than for payment of services rendered. I understand that if an offer of employment is made, that the offer in contingent upon passing an alcohol and drug test. If the test result is positive, the offer will be withdrawn. I understand that employment at this company is “at will” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statue. All employment is continued on that basis. I understand that no supervisor of this company other than one of the owners of Harshman Construction has any authority to alter the foregoing. I herby acknowledge that I have read and understand the above statements.SignatureDate MM slash DD slash YYYY
