ONLINE EMPLOYMENT APPLICATION

If you are interested in a position at D&M Concrete Construction Inc, please fill out the following online application form. Our staff will review it and get back to you as soon as we can.

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Are you eligible to work in the United States?*
If under 18, please list your age
Have you ever been employed by D&M Concrete Construction Inc?*
If yes, dates of employment & reason for leaving:
Are you related to any current D&M Concrete Construction Inc. employee?*
If yes, their name & their relationship to you:
Position Applied For:
Salary Desired:
How many hours can you work weekly?
Can you work nights?
Employment Desired:
- FULL - TIME ONLY
- PART - TIME ONLY
- FULL - OR PART - TIME
When are you available for work?
EDUCATION & OTHER INFORMATION
Did you attend High School?
High School Name
Highest High School grade completed
More High School Information
If there is anything else you would like to tell us about regarding high school, please enter it here.
Did you attend College?
College Name
Number of College years Completed
College Degree
More College Information
If there is anything else you would like to tell us about regarding college, please enter it here.
Have you attended a trade school?
Trade School Name
More Trade School Information
If there is anything else you would like to tell us about regarding trade school experience, please enter it here.
Have you ever been convicted of a crime?
If yes, explain number of conviction(s), nature of offense(s) leading to convic tion(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Do you have a driver’s license?
What is your means of transportation to work?
Driver’s License Number:
State of issue:
State
Driver’s License Expiration Date:
Have you had any accidents during the past three years?
Have you had any moving violations during the past three years?
CERTIFICATIONS
Are you currently CPR certified?
Are you currently certified to be a Flagger?
Do you currently or have you ever held a RapidGate certification?
Do you currently or have you ever held a TWIC card?
REFERENCES
Please list two references ot her than relatives or previous employers
Reference #1
Please include: Name, Address, Phone, Their relation to you
Reference #2
Please include: Name, Address, Phone, Their relation to you
MILITARY
Have you ever been in the armed forces?
Are you now a member of the national guard?
Additional Military Information
Please provide details of your military experience including your specialty and any discharges.
WORK EXPERIENCE
Please list your work experience for the past 3 jobs beginning with your most recent job held. If you were self-employed, give firm name.
EMPLOYER #1
EMPLOYER #1 Start Date
MM slash DD slash YYYY
EMPLOYER #1 End Date
MM slash DD slash YYYY
EMPLOYER #1 Name of Last Supervisor
EMPLOYER #1 Phone
EMPLOYER #1 Description and Information
Please include your duties performed, skills used or learned, advancements or promotions while you worked at this company and reason for leaving.
EMPLOYER #2
EMPLOYER #2 Start Date
MM slash DD slash YYYY
EMPLOYER #2 End Date
MM slash DD slash YYYY
EMPLOYER #2 Name of Last Supervisor
EMPLOYER #2Phone
EMPLOYER #2 Description and Information
Please include your duties performed, skills used or learned, advancements or promotions while you worked at this company and reason for leaving.
EMPLOYER #3
EMPLOYER #3 Start Date
MM slash DD slash YYYY
EMPLOYER #3 End Date
MM slash DD slash YYYY
EMPLOYER #3 Name of Last Supervisor
EMPLOYER #3 Phone
EMPLOYER #3 Description and Information
Please include your duties performed, skills used or learned, advancements or promotions while you worked at this company and reason for leaving.
APPLICATION FORM WAIVER*
In exchange for the consideration of my job application by D&M Concrete Construction, Inc. (hereinafter called “the Company”), I agree that:
Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit p lans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of D&M Concrete Construction, Inc. , or otherwise to change in any respect the employment -at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and D&M Concrete Construction, Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.
I also understand that (1) the Company has a drug and alc ohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.
I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additi onal information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.
I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.
- I CONSENT
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ONLINE EMPLOYMENT APPLICATION

EDUCATION & OTHER INFORMATION

CERTIFICATIONS

REFERENCES

MILITARY

WORK EXPERIENCE

Affiliates and Memberships

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