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Personal

First
M

Address

City
State

County
Phone


Education

High School:
yesno
Years Completed
College:
yesno
Years Completed

Institution


Emergency Contact

First
M

Address

City
State


Work Experience

(select all that apply)

Laborer:
Concrete Floor Placement
Concrete Wall Placement
Fine Grade
Backfill / Compaction
Form Handling
Vibration
Concrete Pump Hose Man
Line and Grade
Crane / Material Hoisting
Carpenter:
Framing / Finish
Decks
High Walls
Low Walls
Edge Forms
Line and Grade
Blueprint Reading

Iron Worker:
Reinforcing Steel
Structural
Line and Grade
Blueprint Reading
Wire Mesh

Truck Driver:
Light Truck
Tractor Trailer

Construction Market You Have the Most Experience In:
ResidentialLight CommercialHeavy CommercialIndustrialHeavy and Highway

Degree of Skill Achieved in the Position Applied For:
Apprentice/TraineeJourneymanForemanSuperintendentOther
Other

Are you willilng and able to work overtime as requested or required?
yesno

Are you willing and able to work all shifts as requested or required?
yesno

Are you willilng and able to work in the states of OH, IN, and KY?
yesno

Do you have reliable transportation to travel to the various job sites?
yesno

As a condition of employment, a drug test will be required after an offer of employment has been made. All tests must be negative. Are you willing and able to take a drug test?
yesno

Employment History

Start with your present or most recent position.

Employer 1:

Address

Title

Reason for Leaving

Start Date

End Date

HourlySalary
Starting Salary

Ending Salary


Employer 2:

Address

Title

Reason for Leaving

Start Date

End Date

HourlySalary
Starting Salary

Ending Salary


Employer 3:

Address

Title

Reason for Leaving

Start Date

End Date

HourlySalary
Starting Salary

Ending Salary


Employer 4:

Address

Title

Reason for Leaving

Start Date

End Date

HourlySalary
Starting Salary

Ending Salary



Other Work Skills / Experience


Office Equipment:

Computer Skills:
MS WordWordperfectExcelPublisherPowerPoint

Other Software:

Special or unusual skills, licenses, professional designations:

American Concrete Pumping Co. is an Equal Opportunity Employer. American Concrete Pumping Co. will not discriminate against employees or applicants for employment on any legally recognized basis including, but not limited to race, age (as defined in the Age Discrimination in Employment Act, as amended), color, religion, sex, marital status, pregnancy or other related illnesses arising from pregnancy or childbirth, national origin, physical or mental disability or veteran status. Employees are expected to abide by the Company Substance Abuse and Drug Free Workplace Policy.

Nothing on the application is intended to create or imply a contractual relationship. If hired, the employee understands that employment is at will, i.e., that is not for any specific time period or duration, and can be terminated by either the employee or American Concrete Pumping Co. with or without reason at any time. While employment policies or procedures may change from time to time, only a written agreement signed by the Company President can change the employee's at will status.

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the Company's Policies. I understand that consideration for employment is conditioned upon the results of a reference check, and that the employer is authorized to investigate all statements made by the applicant on the application/resume and to contact former employers and references.

I agree to the terms and conditions above.

Applicant Name
Date: