Sta-Bilt Construction
Application  for  Employment

Complete all requested information. Any applicant who provides unrequested information will be automatically rejected from employment consideration. Sta-Bilt  is an Equal Opportunity Employer and will not discriminate, or tolerate discrimination, against any employee or applicant in any manner prohibited by law.   Sta-Bilt is a drug-free workplace.

PERSONAL INFORMATION

Today's Date    SSN#               
Last Name       First Name      
Street Address City, State, Zip
Telephone        E-mail Address  
Eligible to work in the U.S.?  Yes No
Have you ever worked for us under a previous name?  Yes  No
If yes, please provide full name:
Referred by:   
If related to anyone in our employ, name & department:
Are you legally eligible for employment? (If hired, you will be required to submit proof of employment eligibility)  Yes  No
Are you of legal age to work?  Yes  No
Drivers License #      CDL#  Yes  No  
CDL Endorsements:


EMPLOYMENT DESIRED

Position Date Available
Salary Desired
Currently employed?  Yes No   
 If yes, may we contact your present employer? Yes No

EDUCATION

High School Year Completed Course of Study
College       Year Completed Degree/Specialty
Other          Year Completed Degree/Specialty
 

EMPLOYMENT HISTORY

Present and former employers listed will be contacted as references if you are a finalist for a position. If you do not have a history of at least three employers, please provide the names, addresses, and telephone numbers of other references who are not related to you.

1
Employer  Position Held
Address   Immediate Supervisor
Brief Description of Duties:

Dates of Employment:  to Salary (Start to Final) to
Reason for Leaving: 
Account for period between jobs:
2
Employer Position Held
Address   Immediate Supervisor
Brief Description of Duties:

Dates of Employment:  to Salary (Start to Final) to
Reason for Leaving: 
Account for period between jobs:

 

By signing below or submitting this form, I certify that the answers and information set out in this application for employment are true, accurate and complete to the best of my knowledge.  I acknowledge that if any answer or information is not true, accurate or complete, I may not be hired, or, if hired, I may be discharged.  I authorize Sta-Bilt to investigate all statements contained in this application for employment and to investigate my character and qualifications.  I authorize my prior employers, references and others with information regarding my work or educational history, or my character, to provide Sta-Bilt with all requested information and references, and to cooperate fully with the investigation of my character and qualifications.  I further release Sta-Bilt, and any person or organization providing information to Sta-Bilt regarding my work or educational history, character or qualifications from any liability for soliciting and securing, or for providing such information.

I understand that this application is not a contract of employment, and I acknowledge that no oral representations have been made as such.  I further understand that I will only be considered for employment opportunities at Sta-Bilt for 90 days from the date of this application.  If hired, I understand that my employment relationship with Sta-Bilt is terminable at-will, with or without cause, by either myself or Sta-Bilt.

In compliance with the Americans with Disabilities Act, I understand that if hired, I will be required to complete an employee health screening medical history statement.  This statement is required of all employees of Sta-Bilt.  Any medical information acquired will be preserved as confidential and kept in a file separate from my personnel file.  If hired, I understand that the job offer I receive will be "conditioned" upon my being able to perform the essential functions of the position with or without reasonable accommodation.

Applicant Signature: _______________________________________ Date:_________________