Employment Form

NOTE TO THE APPLICANT

This application is used to evaluate your qualifications for employment. Please answer all of the questions on your application accurately. If you fail to do so, you may lose employment opportunities or delay consideration of your employment. This application is not an employment contract. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, disability, age, sex (including gender identity and sexual orientation), or any other classification protected by federal, state, or local laws. Additional testing of job-related skills, as well as post-offer pre-employment physical (which will include a drug test) may be required.

A. PERSONAL INFORMATION

B. CRAFT TRAINING, EXPERIENCE, AND READINESS TO WORK

C. EMPLOYMENT

Your training and employment experience will be used to determine whether you meet the entrance requirements for this position and to measure your knowledge, skills, and abilities in completing for this position. Therefore, please provide a full and accurate description of the responsibilities and achievements in your jobs and other pertinent life experiences. Include self-employment, volunteer experience, and any non-employment periods.

List your three most recent positions held, starting with the most recent employer first.

D. SPECIAL SKILLS AND QUALIFICATIONS

CERTIFICATION & RELEASE

I certify that the information contained in this application is true, complete, and accurate. I understand that, if employed, false statements or omissions on this application may result in rejection of my application or discharge at any time during my employment.

I authorize investigation of all statements contained herein. I further authorize all individuals, companies, schools, corporations, courts, and law enforcement agencies to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I release all parties from all liability for any damage that may result from divulging or using information.

I understand and agree that, if hired, my employment is for no definite period and either the company or I can terminate the employment relationship at any time, with or without cause, and with or without notice. This employment relationship exists regardless of any other statements or policies to the contrary.

I realize that upon a contingent offer of employment by JB Holland Construction, Inc., I am required to complete a pre-employment physical and drug test by a physician of JB Holland Construction, Inc. as a condition of my employment. I hereby agree to submit to such an examination and permit disclosure of the results to the company. An offer of employment is contingent upon successfully passing the physical and drug test.

VOLUNTARY SURVEY

JB Holland Construction, Inc. is required by state and federal laws to furnish statistical data and to maintain records of certain population characteristics of those applying for jobs with us. The information you supply will be used for statistical purposes only. If you are offered employment with JB Holland Construction, Inc., it will not be used as employment criteria. JB Holland Construction, Inc. is an equal employment opportunity employer supporting diversity in the workplace. Thank you for you cooperation in completing this form.