We Are Hiring!You think you have what it takes to work with us? Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email Phone (###) ### #### Height * Weight * Are you afraid of heights? Select No Yes Do You have any OSHA training? No Yes, 10hr Yes, 30Hr Do you wear glasses? * Select No Yes Do You have steel-toed shoes? Select No Yes Do you have your own phone? * Yes No Do you have your own transportation? * Select No Yes Do you have a valid driver's license? * Select No Yes If so, Please give Driver's License number: Do you have a forklift license? * Yes No Do you have a CDL License? Select No Yes Have you had any driving violations within the last three years? Select No Yes Do you have any masonry experience? * Select No Yes If so, please explain: Do you speak English? * If so, please rate how well your speak it (10 being fluent) Select No 1 2 3 4 5 6 7 8 9 10 Do you speak Spanish? * If so, please rate how well your speak it (10 being fluent) Select No 1 2 3 4 5 6 7 8 9 10 Do you have any health reasons not to work long, hard hours * Select No Yes If yes, please explain: Do you have any welding, restoration or caulking experience? * Select No Yes If yes, which ones/s and please describe your experience. Do you have any mechanical experience? * Select No Yes If yes, please explain: How did you find out about this job? Do you know anyone that works for Rogers Masonry * Select No Yes If yes, who? If you are under 18 years of age, can you provide required proof of your eligibility to work? Select No Yes Have you ever filled out an application with us before? * Select No Yes If yes, give date: MM DD YYYY Have you ever been employed with us before? * Select No Yes If yes, give date: MM DD YYYY Are you currently employed? * Select No Yes If yes, may we contact your present employer? Select No Yes Are you prevented from lawfully becoming employed in this country? * Select No Yes If there is any other information you believe would be important for us to know while considering your application, please tell us: On what date would you be available for work? * Would you be willing to stay out of town? * Yes No Would you be willing to travel 2 or more hours from your house * Yes No When are you available to work? * Full Time Part Time Temporary Are you currently on "Lay-Off" status and subject to recall? * Yes No Desired Wage Have you been convicted of a felony within the last 7 Years? * (conviction does not necessarily disqualify an applicant from employment) Yes No If yes, please explain: What is the most important feature to you in a job? * What do you like best about your present or previous job? * What do you like least about your present or previous job? * Why did you accept your present or previous job? * What is the most important feature you look for in a supervisor? * State things of interest/hobbies to you: Employer Experience NOTE: This section must be filled out (with phone numbers) to be considered for employment! 1: Employer Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Supervisor First Name Last Name Work Performed Dates Employed: From MM DD YYYY Date Employed to: MM DD YYYY Hourly Rate/Salary: Starting $ Hourly Rate/Salary: Final $ Reason(s) for leaving 2: Employer Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Supervisor First Name Last Name Work Performed Dates Employed: From MM DD YYYY Date Employed to: MM DD YYYY Hourly Rate/Salary: Starting $ Reason(s) for leaving 3: Employer Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Supervisor First Name Last Name Work Performed Dates Employed: From MM DD YYYY Date Employed to: MM DD YYYY Hourly Rate/Salary: Starting $ Reason(s) for leaving References NOTE: This section MUST be filled out to be considered for employment . No family references please. 1: Name First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country 2: Name First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country 3: Name First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country By submitting this application you give permission to contact the above references. To attest that the above information is truthful, and you wish to submit this application for employment, please add your digital signature below: Thank you! Rogers Masonry requires drug testing prior to hiring. Random testing is routinely conducted thereafter.
