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APPLICATION FOR EMPLOYMENT
Strobel Construction Unlimited, Inc. is an Equal Opportunity, Affirmative employer, dedicated to a policy of nondiscrimination in employment on any basis, including race, color, age, sex, religion or national origin. We also comply with the Federal Government "Drug-Free Work Place Act".
PERSONAL INFORMATION
Name_____________________________ Social Security No.____-___-_____
Last
First
Middle
Address_________________________________ Phone(____)____________
City__________________________________ State__________ Zip________
Are you legally eligible for employment in the U.S.A.? Yes_____ No_____
(If yes, verification will be required)
Are you over the age of eighteen? Yes_____ No_____
Date of Birth____________________
Position(s) applied for_____________________________________________
Available Start Date____________________ Wage Desired________________
Were you previously employed by us? Yes_____ No_____
If yes, when?____________________________________________________
If applying for a Welder position, are you certified? Yes_____ No_____
Where?________________________________________________________
EDUCATIONAL INFORMATION
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(Circle highest level completed)
Grammar school 5 6 7 8
High school 9 10 11 12
College 1 2 3 4
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Name and location of school attended
________________________________
________________________________
________________________________
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Did you graduate?
Yes/No
Yes/No
Yes/No
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Are there other experiences, skills, or qualifications relating to the position for which you applied?
_______________________________________________
Were you in the U.S. Armed Forces? Yes_____ No_____
If yes, what branch?_______________________________________________
PERSONAL REFERENCES
(Other than family members of previous employers)
1. Name___________________Phone(____)______________
Address_____________________________
2. Name___________________Phone(____)______________
Address_____________________________
3. Name___________________Phone(____)______________
Address_____________________________
Contact in case of emergency_______________________________
PREVIOUS EMPLOYMENT INFORMATION
1. Company Name___________________Phone(____)______________
Address_____________________________Employed From______To______
Position_______________________Reason for leaving_______________Last Wage______________
2. Company Name___________________Phone(____)______________
Address_____________________________Employed From______To______
Position_______________________Reason for leaving_______________Last Wage______________
3. Company Name___________________Phone(____)______________
Address_____________________________Employed From______To______
Position_______________________Reason for leaving_______________Last Wage______________
PLEASE READ CAREFULLY AND SIGN BELOW
The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal. I further understand that this application is not and is not inteded to be a contract of employment, nor does this application obligate the employer in any way if the employer decides to employ me. I understand and agree that my employment is at-will and can be terminated by either party with or without notice, at any time, for any reason or no reason. I also hereby give permission to contact the employers listed above concerning my prior work experience.
Applicant's Signature____________________________ Date______________
If there is a particular employer(s), you do not wish us to contact, please indicate which one(s).____________________________________________________
_______________________________________________________________
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Mail completed application to:
Or fax completed application to:
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Strobel Construction Unlimited, Inc.
Attn.: Personnel Deptartment
P.O. Box 187
Clarks, NE 68628
(308)548-2164
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