CAREERS

Today's Date*

PERSONAL INFORMATION

Name*

First Last

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Position Applied For:*

Full Time
Part Time

Social Security #

Phone*

Cell or Pager #*

Salary Desired*

Do you have a valid driver’s license?*

Are you eligible to work in the USA?*

Are you at least 18 years old?*

Driver License #:*

Expiration Date*

State issued:*

If under 18, do you have a work permit?*

EDUCATION

High School

9
10
11
12

College, Trade, or Business

1
2
3
4

Graduate Studies

Other special knowledge, skill, or qualifications:

EMPLOYMENT HISTORY

List all employment for the past five (5) year starting with the most resent position. All information must be completed. You may attach a resume, however, not in place of completing the required information.

Employed from:

Employed until:

Job title

Employer name

First Last

Employer Address

Street Address Address Line 2 City State ZIP Code

Supervisor name:

First Last

Supervisor Phone #

Reason for leaving

Duties and responsibilities:

Employed from:

Employed until:

Job title

Employer name

First Last

Employer Address

Street Address Address Line 2 City State ZIP Code

Supervisor name:

First Last

Supervisor Phone #

Reason for leaving

Duties and responsibilities:

Employed from:

Employed until:

Job title

Employer name

First Last

Employer Address

Street Address Address Line 2 City State ZIP Code

Supervisor name:

First Last

Supervisor Phone #

Reason for leaving

Duties and responsibilities:

May we contact your current employer for references?

YES
NO

Are you able to perform the essential job functions for the position you are applying for with or without reasonable accommodations?

YES
NO

Have you been convicted of a crime in the past seven (7) years? (A yes response does not automatically disqualify your application.) If “yes” please explain:

YES
NO

Driving Verification

I understand that driving a company vehicle is a possible requirement of the position I am being considered for and that having and maintaining a satisfactory driving record is a condition of my employment. I agree to allow Merlo Construction to check my driving record prior to hire and periodically thereafter. I further agree to report any license suspension, serious accidents or offenses to my supervisor immediately. I understand that Merlo Construction will use this information for employment purposes only and not furnish this information to a third party without my written consent. I agree to release Merlo, its employees and those who supplied you with the information from any liability for any damage which may result from furnishing the requested information or my failure to be hired for the position for which I am applying.

Signature*

Date*

Merlo Construction in an equal opportunity/affirmative action employer. All qualified applicants will be considered without regard to race, color, gender, religion, national origin, marital status, ancestry, citizenship, veteran status, or physical or mental disability.

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PERSONAL INFORMATION

EDUCATION

EMPLOYMENT HISTORY

Driving Verification

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