Have you ever worked under another name? YesNo

Were you referred to us by a current employee? YesNo


Employment desired: Part-TimeFull-TimeTemporary
Willing to work overtime? YesNo

Have you previously been employed by this company? YesNo

Have you ever been convicted of a felony, or pleaded no contest to a felony, or been convicted of a misdemeanor resulting in imprisonment (Conviction will not necessarily disqualify an applicant, but will be considered in relation to the specific job requirements.) YesNo


Graduated? YesNo

Completed? YesNo

Completed? YesNo

Reference 1

Reference 2

Work history 1

May we contact this employer? YesNo

Work history 2

May we contact this employer? YesNo

Work history 3

May we contact this employer? YesNo

I have answered all questions to the best of my ability. If employed, I realize false, misleading or incomplete information I give or withold on this application or during my interview(s) or at any other time during the hiring process may disqualify me from employment or may lead to my discharge once I have been hired.

I agree that any employment relationship with this Company will be of an "at-will" nature, meaning I may resign at any time and the Company may discharge me at any time, with or without cause and with or without prior notice. I understand that this "at-will" employment relationship may not be changed by any written document, oral statement or conduct unless the change is specifically acknowledge in writing by the Company's President. I understand that any oral or written statements that differ from this explanation of the at-will nature of employment at this Company are expressly disavowed and I understand that I should not rely on such statements. If required by the position applied for, I understand I may have to undergo physical examinations, drug screenings, background, driving, ability or other tests during the application process or after a conditional offer of employment is extended.

I understand that the company will perform a reference check before considering me for employment; if an offer is extended, I understand the Company may also conduct a background check and, depending on the position, may conduct drug testing. I authorize this company to: (1) investigate the truthfullness of all statements made on this application; (2) contact my former employers and other listed references or any other persons who can verify information; and (3) discuss the results of any investigation with other employees of the company involved in the hiring process. I give my consent for all contacted persons, firms and corporations, including former employers to provide information concerning this application, and I release each such person, firm, from liability for providing information to the Company. I also release Integrity Construction, Inc. and its representatives from liability for seeking this information. I further agree to conform to the policies, work rules, and procedures of Integrity Construction, Inc. If I am hired.

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Send me a copy of this message NoYes