Concrete Careers | Buesser Concrete

Name Phone Email Address

City

State

Zip

Where did you hear about this position?

Have you ever pleaded guilty to or been convicted of any criminal offense, excluding minor traffic citations? Yes No

Are you currently serving probation or any deferred adjudication for a criminal offense? Yes No

Cover Letter

Resume

Your Education

Do you have a high school diploma or GED? Yes No

High School/GED City

Your Work History

Please provide your employment data for the last seven years. List your current or most recent position first.

May we contact your present employer at this time? Yes No

Have you ever been discharged or requested to resign? Yes No

Employer

Supervisor Name

Supervisor Phone

Address/City/State/Zip

Starting Hourly Rate

Ending Hourly Rate

Reason for leaving

Start Date

End Date

Position(s) held and major job duties

References

Please list three work and/or education related references. Do not list friends or relatives.

Agreement

I verify that all the information which I have provided on this application and in resumes/exhibits is true, correct and complete. I understand that false, misleading, incomplete or omitted information will result in rejection of my application or dismissal from employment, whenever discovered. If my application is considered for employment, I authorize an investigation and verification of all information and statements provided on this application and in resumes and exhibits. I release any and all persons or companies from any liability for releasing information or verifying statements on this application and in resumes/exhibits.

I understand that this application is not a job offer or a contract of employment for any specific time period. If hired, my employment will be for an indefinite time period and I may resign or be terminated by the facility at any time without notice or requirement of cause.

Employment is subject to completion of pre-employment procedure, including but not limited to verifying employment personal references, criminal record and driving record (where appropriate), and confirmation of professional licensure or registration. Applicants hired must complete a federal I-9 form and provide verifying documentation of their legal right to reside and work in the United States.

Applicants extended a conditional job offer may be asked to submit to a medical exam by a medical practitioner selected by the facility. The exam results will be communicated to the facility and used to determine suitability for employment. In conducting the medical exam, the facility will reasonably accommodate the disabilities and handicaps of qualified applicants in compliance with applicable law. Applicants who refuse to submit to a medical examination will not be further considered for employment.

I further agree that if employed, I will comply with all policies, rules and procedures of the facility. I further give consent for the facility for which I am applying to contact former employers to obtain references and verify information as needed.

By signing and dating this form, I hereby swear all the above information is correct.

By typed first and last names below shall have the same force and effect as my written signature.

Work for Buesser Concrete

Your Information

Your Education

Your Work History

References

Agreement

Thank You!