Graves Construction - Online Application

Application For Employment

Position Applied For:				Date:

A.PERSONAL INFORMATION

	Name:		Social Security #:
	Address:	City:		State:	Zip:
	Telephone number where you can be contacted:
	Are you at least 18 years of age? Yes No
	What is your military status?
	Are you prevented from becoming employed because of visa or immigration status? Yes No
	(if NO, be prepared to provide proof of citizenship or legal residence and work permit to interviewer)
	Will you be able to perform the essential functions of the position for which you have applied? Yes No
	If NO, what accommodation to this condition would make it possible for you to do your job?

	On what date would you be available for work?

CRAFT TRAINING, EXPERIENCE, AND READINESS TO WORK

Are you on a layoff and subject to recall? Yes No

Can you travel if a job requires it? Yes No

If the position you are applying for involves the driving of a vehicle or equipment
which requires a license, do you have a valid license? Yes No

If YES, please specify the type of license: OPERATORS LICENSE COMMERCIAL DRIVERS LICENSE

List the following: License Number: Expiration Date:

Have you had a motor vehicle accident or a moving violation in the past 3 years? Yes No

If YES, please explain:

What types and makes/models of construction equipment can you operate or repair?

List any craft training programs in which you have participated:

Previous Employers: (List present or last job first)

Dates:
From:	To:	Employer:	Job Held/Duties:	Wage/Rate:	Reason For Leaving:

C.	SPECIAL SKILLS AND QUALIFICATIONS

	Summarize special skills and qualifications acquired from employment or other experience:

	Do you have your own craft tools, clothing, and other equipment? Yes No
	Would you accept employment: Out of Town? Statewide? Unaccompanied by Family?
	Have you attended High School, Vocation/Technical School or College? Yes No
	If YES, please specify:

D.	GENERAL

	Who should be notified in case of emergency?
	Name: Address: Phone: (+ area code):

E: VOLUNTARY SURVEY

Graves Construction Co., Inc. is required by state and federal laws to furnish statistical data and to maintain records of certain population characteristics of those applying for jobs with us. The information you supply will be used for statistical purposes only. If you are offered employment with Graves Construction, it will not be used as employment criteria. Graves Construction is an equal employment opportunity employer supporting diversity in the workplace. Thank you for your cooperation in completing this form.

Name:

Phone:

Address:

City:

State:

Zip:

Date:

Position Applied For:

Referral Source: (How did you learn about this position?)

Advertisement		*Where:
Friend
Relative
Walk-in
Employment Agency		*Name of agency:
Other		*Where:

Sex: Male Female

Ethnic Origin
White
Black
Hispanic
Asian/Pacific Islander
American Indian/Alaskan Native
Other

Check any of the following that are applicable:

Vietnam Era Veteran Disabled Veteran Disabled Individual


				Please Read
				" 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, and I agree to hold my employer harmless in the event of my dismissal based thereon. I authorize investigation of all statements contained herein and to do background checks to give you all information concerning my previous employment and any pertinent information they may have, confidential or otherwise, and release all parties from liability for any damage that may result from furnishing same to you. I realize that under certain provisions of Iowa law, pre-employment drug testing could be a condition of my employment. I also acknowledge that the employer may require drug testing at a subsequent time providing that proper advance notice of testing is provided. I also recognize that I could be offered employment subject to appropriate medical examination and that such a report could nullify my ultimate employment by this employer. I agree to submit to physical examination if required. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the method of payment of my wages and salary, be terminated at any time without prior notice. If employment is obtained under this application, I will comply with all the rules and policies of my employer."