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Western Water Constructors, Inc.

General Engineering Contractors

License No. 188068

Application For Employment

Date:
9/8/2010
First Name:
 
Last Name:
Email:
Address:
City:
 
State:
 
Zip:
Telephone:
 
Cellphone:
Date of Birth:
(mm/dd/yy, i.e. 5/15/75)

General

Position Desired:
 
Requested Salary:
Upon request can you provide proof that you are authorized to work in the United States?
Are you over 18 years of age?
Date Available for employment?
(mm/dd/yy, i.e. 5/15/75)
Are you willing to travel?
Have you ever worked for us?
If so, when?
(i.e. summer 2005, 1998-2000,etc.)
Have you ever applied to work for us?
If so, when?
How were you referred to us?
Employee 

Ad 

Publication 

Other 

List any friends and relatives working for Western Water, Inc., and their relationship to you:

Hours

Are you applying for?
Regular Full-Time Work?
Regular Part-Time Work?
Temporary?
(Holiday,Summer) Please Specify:

Education

Some High School
Graduated High School or GED
Some College
Graduated College
Major/Subject Studied:
Trades School
Please Describe (if applicable):

Employment History

Please list your most recent employers (up to 5).
Employer 1
Position
Address
Phone
 
Salary
(hr or mo)
Date Started
(mm/dd/yy)
 
Date Ended
(mm/dd/yy)
Reason For Leaving
Employer 2
Position
Address
Phone
 
Salary
(hr or mo)
Date Started
(mm/dd/yy)
 
Date Ended
(mm/dd/yy)
Reason For Leaving
Employer 3
Position
Address
Phone
 
Salary
(hr or mo)
Date Started
(mm/dd/yy)
 
Date Ended
(mm/dd/yy)
Reason For Leaving
Employer 4
Position
Address
Phone
 
Salary
(hr or mo)
Date Started
(mm/dd/yy)
 
Date Ended
(mm/dd/yy)
Reason For Leaving
Employer 5
Position
Address
Phone
 
Salary
(hr or mo)
Date Started
(mm/dd/yy)
 
Date Ended
(mm/dd/yy)
Reason For Leaving

Other Relevant Background

Specify any special training relevant to the job applied for:
Specify any special skills relevant to the job applied for:
If you are currently employed under written contract with any company, and that contract restricts you in any way in working for a competitor, please specify the restrictions:

Work References

Name
Phone
 
Occupation
Years Known:
 
How Known:
Name
Phone
 
Occupation
Years Known:
 
How Known:
Name
Phone
 
Occupation
Years Known:
 
How Known:

Other

Besides the crime of possession of less than an ounce of Marijuana for personal use more than two years ago, have you ever been convicted of a crime?
If yes, describe the nature of the crime(s), when and where convicted and the disposition of the case:
(A conviction will not necessarily disqualify an applicant for the job applied for. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for will be considered. You may exclude any conviction where the record was judicially ordered sealed, expunged or statutorily eradicated; and any misdemeanor for which probation was successfully completed or otherwise discharged and the case has been judicially dismissed)
Are currently under arrest pending trial?
If yes, describe how it will affect your availability for work, if at all:
Have you ever stolen property or money from a former employer?
Have you ever damaged a former employer’s property?
Do you carry a concealed weapon on your person?
If yes, do you have a permit to do so?
 
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©2006   Western Water Constructors, Inc.    General Engineering Contractors     License No. 188068
707 Aviation Blvd, Santa Rosa, California 95403     707 540 9640 (tel)     707 540 9641 (fax)