EMPLOYMENT
APPLICATION

Personal Information

Name Email
Last First Middle
Address City State Zip Code
Phone Number Social Security Number
Emergency Contact Phone Number

General Information

Position Applied For Application Date
Type of employment desired? Full Time Part Time Seasonal Educational
Referred By Desired Salary Start Date
Have you ever applied to WC Spratt before? If yes, please list the date
Have you ever been employed by WC Spratt? If yes, when? To
If yes, please list supervisor and position
Are you under the age of 18? If yes, can you provide a work permit?
Are you legally eligible to work in this country? Can you provide proof?

*Note: Answering yes to either of the following questions is not an automatic disqualification
Have you ever been involuntarily discharged from a job?
If yes, please explain
Have you ever been convicted of a felony? If yes, please list the date
If yes, please explain

References

Name Title / Relationship
Company Phone Years Known

Name Title / Relationship
Company Phone Years Known

Name Title / Relationship
Company Phone Years Known
EMPLOYMENT
APPLICATION

Employment History

Company Position/Job Title
Address City State
Supervisor Phone Number May We Contact?
Hire Date Leave Date Starting Pay Final Pay
Reason For Leaving
Responsibilities / Duties


Company Position/Job Title
Address City State
Supervisor Phone Number May We Contact?
Hire Date Leave Date Starting Pay Final Pay
Reason For Leaving
Responsibilities / Duties


Company Position/Job Title
Address City State
Supervisor Phone Number May We Contact?
Hire Date Leave Date Starting Pay Final Pay
Reason For Leaving
Responsibilities / Duties


Company Position/Job Title
Address City State
Supervisor Phone Number May We Contact?
Hire Date Leave Date Starting Pay Final Pay
Reason For Leaving
Responsibilities / Duties


EMPLOYMENT
APPLICATION

Education

High School Location Graduated
Did Not Graduate
Obtained G.E.D

College / University Location
Graduated
Did Not Graduate
Still Attending
Major Minor Degree

Other / Trade School Location
Graduated
Did Not Graduate
Still Attending
Major Minor Degree

Experience

Position Experience
Laborer
Skilled Laborer
Operator
Foreman
Superintendent
Estimator
Project Manager
Driver (CDL)
Mechanic (Maintenance)
Administrative 		Work Type Experience
Erosion Control
Clearing
Rough Grading
Utilities / Piping
Concrete
Fine Grading
Punch Out
Directional Drilling 		Equipment Operation
Pipe Saw
Mini Excavator
Excavator
Skide Steer Loader
Track / Wheel Loader
Dozer
Roller
Pan / Scraper
Motor Grader
Gradall

Additional Skills - Comments - Notes

EMPLOYMENT
APPLICATION

Applicant Statement

I understand that any information provided by me that is found to be untrue, incomplete, or misrepresented in any respect, will be sufficient cause to cancel further consideration of this application, or immediately discharge me from the employer's service whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that I will be required to provide proof of work eligibility as required by U.S. law and that other pre-employment tests and checks may be required; and that these documents must be submitted and verified prior to the first day of work.

If employed, I agree to read and comply with the company rules, regulations and policies as outlined in the Safety Program Manual and any other company sanctioned documents.

I understand that the employer does not unlawfully discriminate in employment and no questions on this application are used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the end of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the forgoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

As a condition of employment, PRIOR TO THE FIRST DAY OF EMPLOYMENT, I will be required to submit to and pass a drug/alcohol test.

Employment is probationary for a period of 60 days. The relationship is terminable at will for any reason by either party.

I certify that all the information that I have provided in this application for employment with W.C. Spratt, Inc. is true, complete and correct.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Signature of Applicant Date