Application Name*Name First Middle Last How did you hear about us?How did you hear about us? Name of employee who referred you:Name of employee who referred you: Home Address*Home Address Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address (if different than home address):Mailing Address (if different than home address): Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number (mobile):*Phone Number (mobile):Secondary Number (home or spouse):*Secondary Number (home or spouse):Email*Email Race*Race Black White Hispanic or Latino Two or more races Asian Native American or Alaskan Native Native Hawaiian or Pacific Islander Sex*Sex Male Female Job applying for (check all that apply):*Job applying for (check all that apply): Laborer Operator Crane Operator Carpenter Pipe Layer Welder Concrete Finisher Concrete Foreman Lowboy Truck Driver Mechanic Superintendent Project Manager Estimator Previously employed by Malouf Construction?*Previously employed by Malouf Construction? Yes No Do you have proof of your eligibility to work in the United States?*Do you have proof of your eligibility to work in the United States? Yes No Do you have a drivers license?*Do you have a drivers license? Yes No Choose OneState of drivers license?Choose OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseryNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDo you have a commercial drivers license?*Do you have a commercial drivers license? Yes No Choose OneState of commercial drivers license?Choose OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseryNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDo you have transportation?*Do you have transportation? Yes No Have you ever been convicted of, or plead guilty or no contest to any crime?*Have you ever been convicted of, or plead guilty or no contest to any crime? Yes No If yes, please explain with an approximate date:If yes, please explain with an approximate date: (Criminal convictions are not an automatic bar to employment; all circumstances will be considered.) Have you ever had employment terminated for a cause?*Have you ever had employment terminated for a cause? Yes No If yes, please explain with name of employer.If yes, please explain with name of employer. EducationPlease indicate the number of years of attendance and any degrees you attained.High School - Number of Years*High School - Number of Years High School - Did you graduate?*High School - Did you graduate? Yes No High School AttendedHigh School Attended Vo-tech - Number of Years AttendedVo-tech - Number of Years Attended Vo-tech - Did you graduate?Vo-tech - Did you graduate? Yes No Vo-tech - Degree AttainedVo-tech - Degree Attained College - Number of Years AttendedCollege - Number of Years Attended College - Did you graduate?College - Did you graduate? Yes No College - Degree AttainedCollege - Degree Attained Please list any courses taken as part of your craft background.Please list any courses taken as part of your craft background.Training & ExperiencePlease check all that apply.*Please check all that apply. Form Carpenter Carpenter Foreman Concrete Finisher Reinforcing Steel/Iron Work Welder Plumber Pipe Layer Pipe Fitter Dump Truck Driver Construction Laborer Surveyor Mechanic Lowboy Truck Driver Dozer Operator Backhoe Operator Trackhoe Operator Crane Operator Mini Excavator Operator Other If other, please explain:If other, please explain: Can you interpret construction blue prints?*Can you interpret construction blue prints? Yes No Employment HistoryName of Current Employer*Name of Current Employer Address*Address Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Supervisor*Name of Supervisor Dates of EmploymentFrom:From: MM slash DD slash YYYY To:To: MM slash DD slash YYYY Positions Held*Positions HeldWage (beginning and ending):*Wage (beginning and ending): Reason for leaving:*Reason for leaving: May we contact them? (We understand if you do not wish for us to contact your current employer).*May we contact them? (We understand if you do not wish for us to contact your current employer). Yes No Name of Previous Employer (list from most recent to oldest):Name of Previous Employer (list from most recent to oldest): AddressAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Supervisor:Name of Supervisor: Dates of EmploymentFrom:From: MM slash DD slash YYYY To:To: MM slash DD slash YYYY Positions Held:Positions Held: Wage (beginning and ending):Wage (beginning and ending): Reason for Leaving:Reason for Leaving: May we contact them?May we contact them? Yes No Name of Previous Employer (list from most recent to oldest):Name of Previous Employer (list from most recent to oldest): AddressAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Supervisor:Name of Supervisor: Dates of EmploymentFrom:From: MM slash DD slash YYYY To:To: MM slash DD slash YYYY Positions held:Positions held: Wage (beginning and ending):Wage (beginning and ending): Reason for leaving:Reason for leaving: May we contact them?May we contact them? Yes No Name of Previous Employer (list from most recent to oldest):Name of Previous Employer (list from most recent to oldest): AddressAddress Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Supervisor:Name of Supervisor: Dates of EmploymentFrom:From: MM slash DD slash YYYY To:To: MM slash DD slash YYYY Positions held:Positions held: Wage (beginning and ending):Wage (beginning and ending): Reason for leaving:Reason for leaving: May we contact them?May we contact them? Yes No Due to the nature of construction work, this application will be considered active for one year. If you are not called for an interview or hired during this period, it will be necessary to re-apply for further consideration. Malouf Construction LLC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or national origin. We have formulated an affirmative action program to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any misleading or incorrect statements may render this application void, and if employed, would be cause for termination whenever discovered. I authorize you to make such investigations and inquiries of my personal, employment, financial or other related matters as may be necessary in arriving at an employment decision. I further release all parties from any and all liability for any damages flowing from the gathering and issuing of this information. I understand and agree that, if hired, my employment is at will and that it can be terminated at any time for any reason or for no reason at all. Following a conditional offer of employment, if requested, I agree to submit myself for a physical examination (including blood, urine and other tests such as drug and alcohol tests) by persons designated by the company and to any future tests and/or examinations that the company may require. I further authorize the release of the results of any physical examination and/or drug/alcohol test to Malouf Construction LLC and release all parties from any and all liability in any way associated with or resulting from such physical examination and/or test and/or the reporting of the test results. I have read the foregoing agreement and accept the terms therein stated. Please sign below. Signature* Reset signature Signature locked. Reset to sign again Date*Date This release covers all dates employed by Malouf Construction from this day forward. If I leave Malouf Construction and re-employed at a later date, this release will remain in effect.
