NON-DOT EMPLOYMENT APPLICATION FORM


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NON-DOT EMPLOYMENT APPLICATION FORM

Please be aware that when you submit this application you are also certifying that the information you are giving is correct and accurate. By submitting your application you are agreeing to the following conditions:

I understand that when I submit this form online I certify that the facts set forth in this Employment Application are true and complete to the best of my knowledge. I understand that falsification, omissions or misstatements may prevent my being hired, or if already hired, may subject me to dismissal. I authorize Park Construction Company to make a thorough investigation of my entire work history, and to verify all data given in my application for employment. I release from liability any person giving or receiving information regarding my personal history, medical information and prior work record. I understand and agree that my employment is for no definite period of time and may be terminated by this company at any time without liability for wages or salary except such as may have been earned at the date of termination. I understand that, if hired, I will abide by all the rules and regulation of Park Construction Company.


Non-DOT Employment Application Form

  • (*) IS A REQUIRED FIELD
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  • Education

  • School 1: NameCityStateNo. YearsGraduate?Subject/Degree 
  • School 2: NameCityStateNo. YearsGraduate?Subject/Degree 
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  • Work History

  • Dates: FromToEmployerAddress 
  • Nature of BusinessHourly Rate StartHourly Rate EndSupervisor 
  • Phone #Fax # 
  • Dates: FromToEmployerAddress 
  • Nature of BusinessHourly Rate StartHourly Rate EndSupervisor 
  • Phone #Fax # 
  • Dates: FromToEmployerAddress 
  • Nature of BusinessHourly Rate StartHourly Rate EndSupervisor 
  • Phone #Fax # 
  •  
  • References

  • NameAddressOccupationPhone Number 
  • NameAddressOccupationPhone Number 
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  • Applicants Certification and Agreement

  • I certify that the facts set forth in this Employment Application are true and complete to the best of my knowledge. I understand that falsification, omissions or misstatements may prevent my being hired, or if already hired, may subject me to dismissal. I authorized Park Construction Company to make a thorough investigation of my entire work history, and to verify all data given in my application for employment. I release from liability any person giving or receiving information regarding my personal history, medical information and prior work record. I understand and agree that my employment is for no definite period of time and may be terminated by this company at any time without liability for wages or salary except such as may have been earned at the date of termination. I understand that, if hired, I will abide by all the rules and regulations of Park Construction Company.
  • Federal and state laws and regulations prohibit discrimination in employment because of race, color, sex, religion, national origin, age, ancestry, creed, affectional preference, marital status, sexual orientation, status with regard to public assistance, physical or mental handicap, or disabled veteran status.
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  • AFFIRMATIVE ACTION SURVEY

  • As an employer/government contractor, we must comply with government regulations and affirmative action responsibilities. The information requested below will be used to determine if our recruitment efforts are reaching all segments of the community and will meet our reporting requirements. The information will be used and kept confidential in accordance with the applicable laws and regulations, including those that require the information to be summarized and reported to the Federal Government for Civil Rights enforcement. When reported, the data will not identify any specific individual. This information is voluntary.
  • Military BranchRank 
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  • Form Submission

  • Accepted file types: jpg, png, pdf.
  • This field is for validation purposes and should be left unchanged.