APPLICATION FOR EMPLOYMENT

We are an Equal Opportunity Employer. It is our express policy to employ and advance individuals based upon their qualifications and abilities without regard to race, color, religion, sex, age, handicap (provided it does not interfere with job performance with reasonable accommodation), nation origin, or veteran status.

Personal Information

You will be required to provide your social security and drivers license/state ID for pre-employment approval.
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Home Phone
Date of Birth*
MM slash DD slash YYYY
Age*
Please enter a number from 2 to 100.
Are you 18 years or older?*
- Yes
- No
Do you have the legal rights to work in the United States?*
- Yes
- No
Have you worked for this company before?*
- Yes
- No
When was the date of last employment with Guinn Construction?*
MM slash DD slash YYYY
Reason for leaving/termination.*
Are you employed now?*
- Yes
- No
How long has it been since you left your last place of employment?*
Has someone referred you?*
- Yes
- No
Referral Name*
First Last
Do you have your own reliable transportation?*
- Yes
- No
Are your willing to travel?*
- Yes
- No
Do you have a valid Driver License?*
You will be required to provide your drivers licenses or state ID for pre-employment approval.
- Yes
- No
What position are you applying for?*
You will be required to provide your drivers licenses or state ID for pre-employment approval.
- Labor
- Equipment Operator
- Crane Operator
- CDL Driver
Wage desired*
Have you ever been convicted of a crime?*
- Yes
- No
Please explain the crime you were convicted of, the date of the conviction, and the outcome of the situation.*
Special Skills
Equipment Operated
Is there any reason you might not be unable to perform the functions of the job for which you are applying for?*
- Yes
- No
Please explain why you are unable to perform the functions of the job for which you are applying for.*
Any additional information you want us to know about yourself.
Education Information
High School*
Years completed in high school*
Did you graduate from high school?*
- Yes
- No
Year Graduated*
MM slash DD slash YYYY
College
Years completed in college
Did you graduate from college?
- Yes
- No
Year Graduated*
MM slash DD slash YYYY
Employment Information

All driver applicants to drive in interstate commerce must provide the following information during the preceding 3 years. List complete mailing address, street number, city, state, and zip code.

Applicants to drive a commercial motor vehicle* in intrastate/interstate commerce shall also provide an additional 7 years information on those for whom the applicant operated such vehicle. (List employers in reverse order starting with the most recent. Add another sheet as necessary.)
Do you have previous work experience?*
- Yes
- No
Most Recent Employer Information
Employer Name*
Date Employed*
MM slash DD slash YYYY
Date Left/Terminated*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Personnel Name*
First Last
Contact Personnel Phone Number*
Position Held*
Salary/Wage*
Was your job designated as a safety-sensitive function by any DOT-regulated mode subject to the drug and alcohol testing requirements pf 49 CFR part 40?*
- Yes
- No
Reason for leaving/termination?*
Second Most Recent Employer Information
Employer Name*
Date Employed*
MM slash DD slash YYYY
Date Left/Terminated*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Personnell Name
First Last
Contact Personnell Phone Number
Position Held
Salary/Wage
Was your job designated as a safety-sensitive function by any DOT-regulated mode subject to the drug and alcohol testing requirements pf 49 CFR part 40?
- Yes
- No
Reason for leaving/termination?
Additional Employer Information
Employer Name
Date Employed
MM slash DD slash YYYY
Date Left/Terminated
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Contact Personnell Name
First Last
Contact Personnell Phone Number
Position Held
Salary/Wage
Was your job designated as a safety-sensitive function by any DOT-regulated mode subject to the drug and alcohol testing requirements pf 49 CFR part 40?
- Yes
- No
Reason for leaving/termination?
Personal References

First Reference Information
Name
First Last
Phone
Relationship
How long have you known reference 1?
Second Reference Information
Name
First Last
Phone
Relationship
How long have you known reference 2?
Third Reference Information
Name
First Last
Phone
Relationship
How long have you known reference 3?
Emergency Contacts

First Emergency Contact Information
Name*
First Last
Phone*
Relationship*
Second Emergency Contact Information
Name*
First Last
Phone
Relationship
Disability/Handicap & Veteran Information

It is the policy of this company to comply with the various federal laws, which protect individuals with handicaps, disabled veterans, and veterans who served on active duty during the Vietnam Era for more that 180 days. In accordance with these laws, we invite persons with handicaps, disabled veterans, or veterans of the Vietnam Era to identify themselves for purposes of our Affirmative Action Program. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. This information will be kept confidential to the extent possible, except that:
1. Supervisors and managers may be informed if accommodation is necessary or if your duties are restricted.
2. Government representatives may be informed in compliance with various laws and regulations.
3. First aid and safety personnel may be informed when necessary.
In further explanation is needed on any of the above, contact the personnel manager. Our handicap and veterans Affirmative Action Program available, upon request, in the personnel office on regularly scheduled work by advance appointment. Please answer the following questions.
Are you handicapped or have a disability?
- Yes
- No
Do you possess or can you suggest any special methods, skills, or procedures which might qualify you for positions that you might not otherwise be able to do because of your handicap/disability?
Are you a disabled veteran?
- Yes
- No
Are you a Vietnam Era veteran who served on active duty for more than 180 days during the Vietnam War?
- Yes
- No
In keeping with our Affirmative Action Requirements, what is your gender?
- Male
- Female
In keeping with our Affirmative Action Requirements, what is your nationality?
- American Indian/Alaskan Native
- Hispanic/Anglo-Saxton (not White)
- Black
- White (not Hispanic)
Form Verification
Guinn Construction's Terms & Conditions*
Terms & Conditions
- I verify I have read and understand Guinn Construction's Terms & Conditions policy.
Guinn Construction's Medical Exam & Drug Test Policy*
Medical Exam & Drug Test Policies
- I verify I have read and understand Guinn Construction's Medical Exam & Drug Test Policies.
Guinn Construction's Invitation to Handicapped & Disabled Veterans*
Invitation to Handicapped & Disabled Veterans
- I verify I have read and understand Guinn Construction's Invitation to Handicapped & Disabled Veterans.
By typing your name here, you agree to the following: By submission of this application, I assert that all statements and answers given here are the truth. I give Guinn Construction representatives permission to verify that the information is true and correct.
First Last
Initials*
Date*
MM slash DD slash YYYY
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

APPLICATION FOR EMPLOYMENT

Personal Information

Education Information

Employment Information

Most Recent Employer Information

Second Most Recent Employer Information

Additional Employer Information

Personal References

First Reference Information

Second Reference Information

Third Reference Information

Emergency Contacts

First Emergency Contact Information

Second Emergency Contact Information

Disability/Handicap & Veteran Information

Form Verification