Employment

Date*

Job Applying for*

Project Manager, Superintendent, Laborer, etc.

Name*

First Last

Address*

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

Email*

Enter Email Confirm Email

Primary Phone*

Secondary Phone

Birth Date*

Marital Status*

Single
Married
Other

Education: Click Highest Grade/Degree Completed*

Driver's License*

No
Yes

If "Yes," Add Driver's License Number and State (Note: Photocopying of License May Be Required)

Do You Have Your Own Transportation?*

Yes
No

Have You Had Any Driving Violations or Accidents In The Last Year?*

Yes
No

If You Have Had A Driving Violation Or Accident In The Last Year, Please Explain

List Any Construction Experience Or Specialized Skills (First Aid, Lift Operation, Special Equipment Training, OSHA Training, etc.) Be Specific*

Are You Currently Employed?*

Yes
No

If You Are Currently Employed, Please State The Name Of The Company, How Long You Have Been There, And What Duties You Perform (Be Specific)

List Your Previous Employer, Including Company Name, If We May Contact Them, And What Duties You Performed (Be Specfic), Also Include Your Reason For Leaving That Company

Please Include A Personal Reference*

First Last

Phone

Relationship

Emergency Contact Name

First Last

Emergency Contact Address*

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

Relationship*

Emergency Contact Primary Phone

Emergency Contact Secondary Phone

Did You Serve In The U.S. Armed Forces?*

Yes
No

If You Are A U.S. Armed Services Veteran, Please List Branch And Dates of Service

Do You Have Any Limitations From Working Every Day?*

Yes
No

Are You Able To Stand For 8+ Hours A Day, And Can You Lift Up To 80 Lbs.?*

Yes
No

Please Explain Any Limitations To Standing or Lifting.

Do You Have Any Issues Pertaining To Working Long Hours, Working Out Of Town, Working On Weekends As Necessary?*

Yes
No

If Yes, Please Explain

How Many Days Of Work Have Your Missed In The Last Six (6) Months*

If You Missed More Than Two (2) Days Of Work In The Last Six (6) Months, Please List Why

Have You Ever Been Convicted Of A Felony Or Misdemeanor*

Yes
No

If Yes, Please Explain

Please List Desired Hourly Wage*

Authorization & Acknowledgements: By Clicking The Submit Button, I understand that random drug-screening is a policy at High Rock Waterproofing, Inc. I consent to the testing and understand that failure to successfully complete a drug test may immediately terminate employment. I understand that High Rock Waterproofing, Inc. conducts criminal background checks prior to employment. High Rock Waterproofing, Inc. verifies Social Security numbers thru the Social Security Administration. I am aware that by submitting this application I give permission for full disclosure of all records concerning myself, for purposes of employment.*

I Agree To These Terms

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Employment Application