Personal Information
Name
Email
Phone
Birthdate
Citizenship Status
U.S. Citizen
Not a U.S. Citizen
Address
Street Address
City
State
ZIP / Postal Code
Career Information
Position Desired
Employment Desired
Full-Time
Part-Time
Other
Years of Related Experience
Date Available to Start
Are you willing to work any shift?
If no, please explain.
History
Have you ever been convicted of a felony or misdemeanor?
Are there any felony charges currently pending against you?
If you answered yes to the questions above, please provide the following information: Date of the Offense, Offense, Place, and Disposition for each offense.
Personal References
Please provide 3 References UNRELATED to you that you have known for 2 years or more.
Name (Reference 1)
Phone Number (Reference 1)
Name (Reference 2)
Phone Number (Reference 2)
Name (Reference 3)
Phone Number (Reference 3)
Resume
Please provide a copy of your resume. (pdf, doc, or docx)
AGREEMENT #3
By checking this box, if offered employment, I agree and consent to provide blood and urine specimens for alcohol and drugscreening analysis. I understand and agree that Visscher Construction, Inc., may require me to undergo a physical examination. I also consent to an investigation of my driving record, and, when appropriate a full background investigation. I understand that any offer of employment by Visscher Construction, Inc., will be contingent on the results of such investigation, alcohol and drug screening, and physical examination. I acknowledge that Visscher Construction, Inc. has a zero-tolerance drug policy, and that violation of the same represents misconduct for purposes of employment termination.
AGREEMENT #4
By checking this box, I understand that if hired I will be an at-will employee and that my employment and compensation can be terminated at any time, with or without cause and with or without notice, at the option of either Visscher Construction, Inc., or myself. I further understand that no supervisor or representative of Visscher Construction, Inc., other than the President, has any authority to enter into any agreement contrary to the foregoing and that such agreement must be in writing and signed by the President. In consideration of such employment, I agree to conform to the rules and policies of the company, including the arbitration procedure.
Dated
Digital Signature
