Application for Employment
An Equal Opportunity Employer: We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job related information.

Job Applied for *
Desired Pay *
Today's Date *
What kind of employment are you seeking? *
When are you available to begin work?
Last name, First name, Middle Name *
Telephone Number *
Are you 18 years of age or older? *
If you are hired, you may be required to submit proof of age.
Present Street Address *
State *
Zip Code
Social Security Number
If hired, can you furnish proof you are eligible to work in the US? *
Have you ever applied here before? *
If you've applied here before, when?
Have you ever been employed by Envirostruct, LLC? *
If you've ever been employed here, when?
Have you ever been convicted of any law violation? *
Include any plea of "guilty" or "no contest." Exclude minor traffic violations.
If you answered yes to the above, give details.
A conviction will not necessarily disqualify an applicant for employment.
If employed, do you expect to be engaged in any additional business or employment outside of our job? *
If yes, give details.
Do you have a valid driver's license?
Driver's license number
Class of License
State licensed in
Have you ever been convicted of a DUI?
Have you ever been convicted of reckless driving?
Have you had any accidents in the last three years?
If yes to any of the three above, please explain and include conviction dates.
Have you had your driver's license suspended or revoked in the last 3 years? If yes, give details.
List name and address of High School or GED *
List name and address of College or University *
List name and address of Vocational or Technical school *
What skills or additional training do you have that relate to the job for which you are applying? *
What machines or equipment can you operate that relate to the job for which you are applying? *
List names of employers in consecutive order with present or last employer listed first. Include Job title/duties, address, supervisor, supervisor telephone, dates of employment, beginning and ending pay, and reason for leaving. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references. *
Note: A job offer may be contingent upon acceptable references from current and former employees.
Have you worked or attended school under any other names? *
If yes, give names.
Are you presently employed? *
If yes, whom do you suggest we contact?
Have you ever been fired from a job or asked to resign? *
If yes, please explain.
Give three references, not relatives or former employers. *
If you have a resume, upload it here.
Please read each statement carefully before signing. *
I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE. I have read, understand, and by my signature consent to these statements.
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