Name:
Home phone number:
Alternate phone number:
Date of birth:
Personal History
Current address:
City:
State:
How long have you lived at this address?:
Own
Landlord name
Landlord telephone:
Previous address:
City:
State:
How long did you live at this address?:
Own
Landlord name (if renting):
Landlord telephone:
Do you smoke?
Have you ever been convicted of a crime?
If yes, please explain why:
Have you ever served time in prison or jail?
If yes, please explain why:
Do you have a valid Driver's License?
If not, please explain why:
Is your Social Security number valid?
If not, please explain why:
Do you have a reliable vehicle to drive yourself to and from work?
Work History
Current or most recent employer:
Start date:
End date:
Name of supervisor:
Supervisor phone number:
Reason for leaving:
Previous employer:
Start date:
End date:
Name of supervisor:
Supervisor phone number:
Reason for leaving:
If you have not been consistently employed, please explain why:
If not consistently employed, did you apply for unemployment?
In which State did you apply?
Did you receive unemployment?
Have you received Worker's Compensation in the past?
Have you ever worked for, or applied for a job at AM-Rail Construction in the past?
If yes, please state dates of employment:
What position are you applying for?
Have you read the job description for this particular job?
Are there any reasons, medical or otherwise, that prevent or restrict you from being able to perform the responsibilities of this job?
If yes, please explain:
Schooling
Did you graduate college?
When?
What was the highest grade of High School you completed?
What year did you graduate High School?
References
Please list three references. References cannot be relatives/family members.
Name:
How long have you known this person?
Phone number:
Relationship:
Name:
How long have you known this person?
Phone number:
Relationship:
Name:
How long have you known this person?
Phone number:
Relationship:
Please take a moment to verify that all questions have been answered. If any questions are left blank or have been skipped, this application with NOT be considered for employment. Write "N/A" next to any question that does not apply to you.
All new hires must agree to take a drug & Alcohol screening test prior to being accepted for employment at AM-Rail Construction. Drug and alcohol tests will also be conducted at random. If applicant refuses to take these screenings, or if results show presence of either drugs or alcohol, this will be a basis for rejecting your application.
Your signature below is evidence that you have read and agree to comply with the above Drug and Alcohol Screening Tests
Type your name here:
Initial here:
Date:
I solemnly swear that the numbers on the Social Secuirty card that I have submitted along with this application are accurate and have not been replaced, altered, or falsified in any way.
Type your name here:
Initial here:
Date:
