General Interest Employment Application

1Application Overview

2Applicant Information

3Education

4Employment History

5References

6Certification

Application For Employment

We consider applicants for all positions without discrimination because of race, color, religion, sex, national origin, age, marital or veteran status, the presence of non-job related medical condition or handicap, union affiliation or any other legally protected status. In accepting it, the Company makes no commitment of employment to the applicant. This application will remain active for 30 days.

WE ARE AN AT-WILL EMPLOYER, MEANING THAT EITHER THE EMPLOYER OR THE EMPLOYEE MAY END THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND FOR ANY OR NO REASON.

Please fill out the application as completely as possible. Enter N/A where appropriate if you have no information to enter.

Employment Experience:

List employer(s) for the last 10 years with the most recent first.
Are You Currently Employed?*
- Yes
- No
If yes, may we contact your current employer?
- Yes
- No
Most Current Employer
Employer Name*
Employer Telephone*
Employer Address*
Street Address City State Zip Code
Employed From:*
MM slash DD slash YYYY

Please select the date you started this job.
Employed To:*
MM slash DD slash YYYY

Please select the date you left this job.
Your Position*
Immediate Supervisor Name & Telephone Number*
Salary (optional for applicant to provide)*
Job Duties*
Reason For Leaving*
Do you have additional employers to list?*
- Yes
- No
2nd Most Current Employer
Employer Name
Employer Telephone
Employer Address
Street Address City State Zip Code
Employed From:
MM slash DD slash YYYY

Please select the date you started this job.
Employed To:
MM slash DD slash YYYY

Please select the date you left this job.
Your Position
Immediate Supervisor Name & Telephone Number
Salary (optional for applicant to provide)
Job Duties
Reason For Leaving
3rd Most Current Employer
Employer Name
Employer Telephone
Employer Address
Street Address City State Zip Code
Employed From:
MM slash DD slash YYYY

Please select the date you started this job.
Employed To:
MM slash DD slash YYYY

Please select the date you left this job.
Your Position
Immediate Supervisor Name & Telephone Number
Salary (optional for applicant to provide)
Job Duties
Reason For Leaving

Personal References:

List references that you have known for more than 2 years
Reference 1
Name
First Last
Address
City State
Phone
Business Name (if applicable)
Years Acquainted
Reference 2
Name
First Last
Address
City State
Phone
Business Name (if applicable)
Years Acquainted
Additional References?*
- Yes
- No
Reference 3
Name
First Last
Address
City State
Phone
Business Name (if applicable)
Years Acquainted

Applicant's Certification Agreement
1. I authorize the investigation of all statements contained in this application and release from all liability any persons or employers supplying such information, and I also release the company from all liability which might result from making the investigation.
2. I certify that this application was completed by me and that the facts and information set forth in this application are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission of facts on this application ( or on any required documents) may result in denial of employment or immediate termination of employment, regardless of when or how discovered.
3. lf l am offered and accept a position, I understand that I will be expected to conform to all existing and future Company rules and regulations and I understand the Company reserves the right to change wages, hours and working conditions as deemed necessary. I ALSO UNDERSTAND THIS APPLICATION DOES NOT CONSTITUTE AN EMPLOYMENT CONTRACT OF ANY KIND. SHOULD THE COMPANY EMPLOY ME, I MAY RESIGN SUCH EMPLOYMENT AT ANY TIME AT MY DISCRETION WITH OR WITHOUT PRIOR NOTICE AND THE COMPANY MAY TERMINATE MY EMPLOYMENT AT ANY TIME AT THEIR DISCRETION, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT PRIOR NOTICE.
4. I understand that any employment offer is contingent upon my providing, within three (3) working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986. The company participates in E-Verify.
5. I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully and honestly.
6. I understand that Miles Sand & Gravel Company is a drug free company. Any offer of employment is contingent upon the applicant's successful completion of pre-employment urinalysis screening and background check.
Name*
First Last
Date*
MM slash DD slash YYYY
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General Interest Employment Application

Application For Employment

Employment Desired

Personal Information

Education:

High School Education

College Education

Other Education

Employment Experience:

Most Current Employer

2nd Most Current Employer

3rd Most Current Employer

Personal References:

Reference 1

Reference 2

Reference 3

Applicant's Certification Agreement