Employment Application - Premier Construction Services

Employment Application - Premier Construction Services

Nuco Construction, Inc. dba Premier Construction Services
Employment Application
Personal
Name/
Nombre
Address/
Direccion
Last/ Apelido
First/ Primer Nombre
M.I.
Date/Feche
Street Address/ Calle
Apartment/Unit #/ Apartamento
City/ Ciudad
State/ Estado
Phone/
(
Telefono
Date Available
Feche Disponible
ZIP Code
Application on file/
¿Uso en archive?
)
Desired
Salary:
Social Security No:
Position Applied for:
Are you a citizen of the United States?
¿Es usted un ciudadano de los Estados
Unidos?
YES
Have you ever worked for this company?
Have you ever been convicted of a felony?
NO
YES
NO
YES
NO
$
If no, are you authorized to work in the U.S.?
Si no, usted se autorizan para trabajar en los
Estado Unidos
YES
NO
If so, when?
If yes, explain:
Are you available to work
Full Time/ Tiempo Completo (day - night - both)
How many hour do you wish to work?
Puede trabajar
Part Time/ Medio Tiempo (day – night- both)
Cuantas horas desea trabajar?
Temporary
Do you have previous janitorial or floor experience?/ ¿Usted tiene experiencia porteril o del piso anterior?
If “yes”, explain:
Yes
No
Are you able to perform the essential functions of the job for
which you are applying, with or without accommodation?
Yes
No, explain:
Have you ever been convicted of a crime? If yes, indicate when, where, and disposition of case(s):
Will you work overtime if asked?
Yes
Yes
No
No
If “yes”, explain:
Do any of your friends or relatives, other than spouse, work here?/ ¿Tiene algun amigo oz. familiar, fuera del isposo, trabajando para
la compañia?
Yes
No If yes, state name, relationship, and location. / Si contesta “yes” de su nombre, relación, y localidad.
Do you have any friends or relatives who might want a job? / Tiene alguien conocido que quiera trabajar?
If “yes”, Name/ Nombre:
Telephone / Telefono:
How did you hear about us?
Education/ Educación
From:
College /
University
To:
Address/
Direccion
Did you graduate?
¿Usted graduó?
YES
From:
College /
University
To:
Address:
Did you graduate?
¿Usted graduó?
YES
From:
To:
Address:
Did you graduate?
¿Usted graduó?
High School:
YES
NO
Degree:
NO
Degree:
NO
Degree:
Yes
No
Personal References / Referencias Personales
Name /
Nombre
Relationship /
Relación
Name /
Nombre
Relationship /
Relación
Name /
Nombre
Relationship /
Relación
Phone:
Phone:
No
Phone:
From:
Address:
Job Title:
)
Phone:
Previous Employment
May we contact your current supervisor for a reference? /
Yes
Podemos contactar su trabajo?
Company:
(
To:
Supervisor:
$
Starting Salary:
Ending Salary:
$
Responsibilities:
May we contact your previous supervisor for a reference? /
Podemos contactar su trabajo?
Company:
Yes
No
Phone:
From:
Address:
Job Title:
To:
Supervisor:
$
Starting Salary:
Ending Salary:
$
Responsibilities:
May we contact your previous supervisor for a reference? /
Podemos contactar su trabajo?
Company:
Yes
Phone:
From:
Address:
Job Title:
No
To:
Supervisor:
Starting Salary:
$
Ending Salary:
$
Responsibilities:
In Case of Emergency, Notify/ En Caso de Emergencia, Notificar
Name /
Nombre
Phone:
I certify that all statements I have made on this application or on my resume or other supplementary materials submitted to Nuco Inc. dba
Premier Construction Services are true and correct to the best of my knowledge, and understand that any misstatements or omissions may result in a
withdrawal of any offer or immediate discharge if I am employed.
I understand that employment and compensation at Nuco Inc. dba Premier Construction Services can be terminated or modified “at-will” or
without cause of advance notice at any time at the option of either myself or Nuco, Inc. dba Premier Construction Services. No representation to the
contrary, oral or written has been made to me by anyone. I also understand that changes to this at will relationship can be made only in writing and signed
by the Company’s designated representative.
I understand that I am entitled to copies of any public records obtained by Nuco Inc. dba Premier Construction Services unless I check the box
below. If I am not hired as a result of such information, I am entitled to a copy of any such records even if I check the box below.
I waive receipt of a copy of any public record described above
______________________________________________________________
__________________________
Applicant’s Signature
Date