Application for Employment Amcrete Concrete Construction is proud to be a drug free workplace Name Last Name * First Name * Middle Address Number and Street * City * State * Zip * Phone * Alternate Phone Email * Are you at least 18 years of age? * YesNo Please state your age * Have you ever applied for a job with the Company before? * YesNo Have you ever worked at the Company before? * YesNo When and for how long? Position for which you are applying * Other position you would like to be considered What experience or skills qualify you for this position? * The normal working hours of the company vary and encompass different shifts, including Saturdays. Without indicating the need for any absences for religious practices during the normal working hours, are you otherwise available to work during these hours? * YesNo Date you could begin working * How did you hear about us? * Education High School * Address * Last year completed * Did you graduate? YesNo Diploma/Degree* College Address Last year completed Did you graduate? YesNo Diploma/Degree Graduate Address Last year completed Did you graduate? YesNo Diploma/Degree Other Address Last year completed Did you graduate? YesNo Diploma/Degree Employment Record Please list most recent position first Company * Phone * Address * Supervisor * Job Title or Duties * Reason for Leaving * Company Phone Address Supervisor Job Title or Duties Reason for Leaving Company Phone Address Supervisor Job Title or Duties Reason for Leaving Company Phone Address Supervisor Job Title or Duties Reason for Leaving Personal References Not former employers or relatives Reference 1 Name * Address Phone * Relationship and years known * Reference 2 Name * Address Phone * Relationship and years known * Years of Experience Laborer * YesNo Years of Experience * Rough Carpentry * YesNo Years of Experience * Iron Work * YesNo Years of Experience * Masonry * YesNo Years of Experience * Heavy Equipment * YesNo Years of Experience * Type of equipment? * CDL * YesNo Years of Experience * Type of CDL? Welding * YesNo Years of Experience * Years of Flux Core Experience Years of Stick Experience Dry Wall Finishing * YesNo Years of Experience * Concrete Finishing * YesNo Years of Experience * Flooring * YesNo Years of Experience * Finish Carpentry * YesNo Years of Experience * Transportation: * SelfOther Please explain * PLEASE READ THE LANGUAGE BELOW CAREFULLY. SHOULD YOU HAVE ANY QUESTIONS REGARDING THIS LANGUAGE, PLEASE SEEK ASSISTANCE PRIOR TO SIGNING THIS DOCUMENT. I certify that the information contained in this application is true, accurate and complete. I understand that falsification of this Employment Application in any detail may result in disqualification from further consideration, or, if hired, immediate dismissal without notice from employment. As a condition of employment, I understand that Amcrete reserves the privilege to thoroughly investigate and verify all information contained in this Employment Application, including but not limited to contacting any of the aforementioned employers, supervisors and references. I agree to indemnify and save harmless Amcrete from and against any liabilities, claims, attorney fees, costs, causes of action or other liability arising directly or indirectly from, or associated with, this Employment Application. I agree to conform to the rules and regulations of Amcrete, and I understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either Amcrete or myself. I further understand that no personnel recruiter or interviewer other than an authorized representative of Amcrete, has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. I have read and agree to the above conditions. Equal Employment Opportunity Information The information supplied below is strictly voluntary and will in no way affect the processing of your employment status with this company. This information sheet will only be used for statistical purposes. Thank you for your cooperation. Sex MaleFemalePrefer not to answer Race Hispanic or Latino: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.White: a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.Black or African American: a person having origins in any of the black racial groups of Africa.Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.Native Hawaiian or Other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.American Indian or Alaska Native: a person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.Two or More Races: a person who primarily identifies with two or more of the above race/ethnicity categories. Disability Are you an individual with a physical or mental impairment which substantially limits one or more of your major life activities? YesNo Veteran Status Are you a Veteran? YesNo