Job Applications for Excavating Contractors - DOC by fal21772

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									                                                                         Steven E. Fuller Excavating, Inc.
                                                                                                      8 Chesterfield Street
                                                                                                              P.O. Box 386
                                                                                                      Keeseville, NY 12944

                                                                                               The Complete Package


EMPLOYMENT APPLICATION

Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran
status, or in the presence of a non-related medical condition or handicap.

Full Name_______________________________________________________Date________________

Mailing Address_____________________________________________________________________

Physical Address_____________________________________________________________________

City_____________________ State_____ Zip__________ Phone #________________________

Are you a citizen of the United States of America? [ ] Yes [ ] No              Are you 18 years or older? [ ] Yes [ ] No

Are you a veteran of the U.S. Military service? [ ] Yes [ ] No

Have you applied here before? [ ] Yes [ ] No When?______ Current position applied for?________________

Start When_______________ [ ] Full time [ ] Part time [ ] Temporary [ ] Other__________________

EMPLOYMENT EXPERIENCE
 Start with your present job or last job. Include military assignments and other volunteer activities. Exclude organizational
names which indicate race, color, religion, sex, or national origin
Employer 1__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________
Employer 2__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate_____________________
Employer 3__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors’ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________


Phone: (518) 834-4617                        Fax: (518) 834-4619          Web: http://www.fullerexcavating.com
EDUCATION
Schools/Collages Attended:                                                # Years     Year Grad. Degree

____________________________________________________                      _______ _______ ___________

____________________________________________________                      _______ _______ ___________

____________________________________________________                      _______ _______ ___________


SPECIAL SKILLS
Describe any special qualifications for this job:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________



EQUIPMENT EXPERIENCE
Please check all pieces of equipment that you have significant experience with.

□ Skidsteer                            □ Loader                                 □ Excavator
□ Bulldozer                            □ Grader                                 □ Dirt Roller
□ Backhoe                              □ Asphalt Paver                          □ Asphalt Roller



The undersigned agrees to release and indemnify Steven E. Fuller Excavating, Inc. information suppliers, their
parent, sister, and affiliate entities as well as officers, employees, contractors, and agents from all liability are
arising form any unauthorized access, improper use, or reliance on information provided pursuant to this agreement.
I hereby certify that this report is being obtained for employment purposes only and authorize the Division of Motor
Vehicles to release my driving record to Steven E. Fuller Excavating, Inc.

Drivers License #_______________________________State__________ Expiration_______________



I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigations
of all statements contained in this application for employment as may be necessary in arriving at an employment
decision. I understand that this application is not intended to be a contract of employment. In the event of
employment, I understand that false or misleading information given on my application or interview may result in
termination.

Signature___________________________________________________Date_____________________




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