Employment Application - Bairco Construction, Inc.

Application for Employment

Personal Information

First Name *

Middle Name

Last Name *

Current Address *

Country

City

State

Zip code

Permanent Address

Country

City

State

Zip code

(if different than Current Address)

Phone *

Position Applied For: *

Skills/Training *

Do you have any relatives who are presently (or have formerly been) employed by Bairco Construction? *

How were you referred to Bairco Construction? *

Have you ever been convicted of a felony? *

Yes

Educational History

Elem/Jr. High

School Name/Location

Years Completed

Degree/Diploma

High School

School Name/Location

Years Completed

Degree/Diploma

College

School Name/Location

Years Completed

Degree/Diploma

Tech Training

School Name/Location

Years Completed

Degree/Diploma

Military Service

School Name/Location

Years Completed

Degree/Diploma

Special Training

School Name/Location

Years Completed

Degree/Diploma

Employment Record

Employment Record 1

Company Name

Current or Most Recent Employer

Position Held

Address

Dates Employed

Manager/Supervisor

Phone

Wage

Reason for Leaving

Employment Record 2

Company Name

Position Held

Addrss

Dates Employed

Manager / Supervisor

Phone

Wage

Reason for Leaving

Employment Record 3

Company Name

Position Held

Address

Dates Employed

Manager / Supervisor

Phone

Wage

Reason for Leaving

Note

Email us a document to list additional employers if necessary. We will contact all of the employers listed on this application unless you specifically exclude them below. Please list any employers you do not want us to contact and your reason for the exclusion:

Employer's Name

Reason

Employer's Name

Reason

Employer's Name

Reason

References

Reference 1

Name

Years Known

Address

Phone

Occupation

Reference 2

Name

Years Known

Address

Phone

Occupation

Reference 3

Name

Years Known

Address

Phone

Occupation

Work Availability

When will you be available to begin work? *

Do you have any objection to working overtime? *

Yes

Can you work overtime without prior notice? *

Yes

Can you work on Saturday? *

Yes

Can you work on Sunday? *

Yes

Can you travel if required? *

Yes

Authorization

"I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.

I ALSO AGREE THAT NO REPRESENTATIVE OF THE COMPANY 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, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE."

Indicate You Agree to the Above Statements *

Yes

Notification to Applicants & Employees

NOTIFICATION TO APPLICANTS & EMPLOYEES

POLICY OVERVIEW

Bairco Construction, Inc. has a vital interest in maintaining safe, healthful, and efficient working conditions for all of its employees. Being under the influence of a drug or alcohol while on the job poses serious safety and health risks, not only for the user, but to all those who work with or otherwise come into contact with the user. The use, possession, or sale of illegal drugs or alcohol while on the job poses unacceptable risks for safe, healthful, and efficient operations.

Bairco Construction, Inc. (hereinafter also referred to as “Company”). Has developed a policy in conforming with Department of Transportation (DOT) Drug and Alcohol Testing Program Regulation 49 CFR Part 40 and Federal Motor Carriers Safety Administration (FMCSA)
Regulation 49 CFR Part 382.

Drivers whose job/duties require them to possess a valid Commercial Drivers License (CDL), and those employees that may perform safety-sensitive functions regulated by DOT Agency
Regulation are subject to the DOT testing regulations and Company Policy. Those employees
covered by DOT regulations, and federal regulations shall be considered as preempting any
inconsistent state or local laws or regulations.

POLICY APPLICATION

The provisions of this drug and alcohol policy apply to all employees who work for Bairco
Construction, Inc. the effective date of this policy is 4/20/2010.

Verification *

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