Pre-Employment Application

Our Company is an equal opportunity employer and will consider all applicants for all positions equally without regard to their race, sex, color, religion, national origin, veteran status, any disability as defined in the Americans with Disabilities Act, or for any other reason protected by State or Federal Law. This application will be given every consideration, but its receipt does not imply that the applicant will be employed. Each question should be answered in a complete and accurate manner as no action can be taken on this application until all questions have been answered.

PERSONAL INFORMATION

Last Name: First: MI:

Present Address: City: State: Zip:

Are you 18 years or older? Yes No Home Phone: Cell Phone:

Are you a citizen of the U.S. or Do you have the legal right to be employed in the U.S.? Yes No

Have you been convicted of (or pleaded no contest to) any crime within the last 10 years (excluding minor traffic violations) including under the influence of alcohol or drugs? [Note: A conviction will not necessarily disqualify you from employment] Yes No

If yes, state the offense, location, date and disposition:

Do you have the ability, with or without reasonable accommodations, to work overtime or to travel if travel and/or overtime are required by the job for which you are applying? Yes No

If no, please explain:

Driver's License:
State: License Number & Type: Currently Valid? Yes No

Employment Desired

Position Applied for: Date You Can Start: Wage Desired:

Are you employed now? Yes No If so, may we contact your present employer? Yes No

Have you ever applied to or worked for Dredging Supply Company before? Yes No If yes, when?

How did you learn of our company and/or position? (Choose only ONE option)



(List their name)



Employment History

List the names if employers in consecutive order with present or most recent employer first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references.

mth

year

name & address of employer

salary

position

reason for leaving

FR

TO

         

FR

TO

         

FR

TO

Education

 

name & location of school

# of years attended

did you graduate?

concentration

high school name

         

college name

         

technical school name

If you did not graduate, why did you leave high school or college?

 

General

List any technical training, skills, or work experience which may qualify you for a job with us:

Describe why you are interested in working for our company:

What languages do you speak fluently?

Military Service

Have you ever served in the military? Yes No Service Branch: Final Rank

What duties or skills would be job related?

Capability/Reliability

Would you be willing and able to perform all the tasks required by the job you are applying? Yes No

If not, explain which tasks:

Have you filed any type of fraudulent claim against your present or past employer? Yes No

If yes, please explain:

Will you abide by the safety rules of this company? Yes No

Have you ever been disciplined for violating company safety rules or regulations? Yes No

If yes, please explain:

How many days of work (or school) have you missed in the last two years?

How many times have you been late to work (or school) in the last two years?

Consistent attendance and punctuality are essential requirements of every job in our company. Would you be willing and able to report to work on time every day on a regular and consistent basis? Yes No

If no, please explain:

Have you ever been disciplined or received a verbal or written warning(s) for absenteeism or tardiness? Yes No

Have you ever been fired, or ask to resign from a job? Yes No

If yes, please explain:

References

name

address

phone

occupation
       
       

 

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate termination.

I hereby authorize the Company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right to bring any cause of action against these individuals for libel, slander, defamation, invasion or privacy or any other reason because of their statements.

I agree that, if I am employed, I will abide by the rules and regulation of the Company. I understand that the taking of drug and alcohols tests, when given pursuant to company policy, are a condition of continued employment and refusals to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the President of the Company. I also understand that my employ is "at-will" and may be terminated by myself or by the company at any time for any reason or no reason at all, with or without prior notice.