Employment - Southeastern Site Development, Inc

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone Number:*

Email

Are you 18 years of age or older?*

Yes
No

Are you either a U.S. citizen or an alien authorized to work in the U.S.?*

Yes
No

Have you ever applied for employment with Southeastern Site Development, Inc.?*

Yes
No

If yes, when:

Job Description:

Who referred you to this company?

Position Desired

Position:*

Start date available:*

Hours you are available to work:*

Days of week you are available to work:*

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Are you able to work:*

Weekends
Holidays
Nights
Overtime

Can you travel if a job requires it?*

Yes
No

Do you have a valid Driver’s License?*

Yes
No

Do you have reliable transportation?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

(Conviction will not necessarily disqualify an application from employment)

If yes, please explain:

Work Experience

List the last 2 positions held below (Most recent first)

Job 1 - Dates

Please list date started and date ended.

Job 1 - Employer's name

Job 1 - Address

Job 1 - Phone

Job 1 - Job title

Job 1 - Salary

Job 1 - Reason for Leaving

Job 2

Job 2 - Dates

Please list date started and date ended.

Job 2 - Employer's Name

Job 2 - Address

Job 2 - Phone

Job 2 - Job title

Job 2 - Salary

Job 2 - Reason for Leaving

For Field Positions

Do you have a CDL License*

I do not have a CDL license
Tractor Trailer
Tandem Dump
Single Axle Dump
Service Truck (Hazardous Material)

Check all that apply

Can you operate any of the following equipment? (Please check one box per row)

Dozer*

Finish Grade
Rough Grade
No

Loader*

Finish Grade
Rough Grade
No

Scraper*

Finish Grade
Rough Grade
No

Rubber Tire Backhoe*

Finish Grade
Rough Grade
No

Track Hoe*

Finish Grade
Rough Grade
No

Motor Grader*

Finish Grade
Rough Grade
No

Compactor*

Finish Grade
Rough Grade
No

List any other qualifications or skills you might have in addition to those listed above:

Authorization and Acknowledgements

I certify the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment are deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period not to exceed one year. I hereby certify that I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge an Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, that I am required to abide by all rules and regulations of the employer. Southeastern Site Development is a drug free work place. All prospective employees are required to submit to drug testing. Employment is subject to successfully passing a drug test(s).

Consent*

I agree to the above statements

Date*