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 APPLICATION FORM

*IS A REQUIRED FIELD

 


 

    Applicant to Complete






    Current Address:





    Do you have the legal right to work in the United States?*
    YesNo



    Are you 18 years of age or older?*
    YesNo



    Have you worked for this company before?*
    YesNo







    Select the option that represents the highest level of completed educational background.*
    High SchoolGEDTrade/Business SchoolCollegeOther





    Enter School Information:








    Employment History


    Current or Last Employer*



    May we contact?*
    YesNo






    Next Previous Employer



    May we contact?*
    YesNo








    References



    List two people not related to you whom you have known for at least 1 year.*




    Applicant 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.



    I (Name) accept the terms above.






    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.




    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.







    Check one:
    MaleFemaleI choose not to declare



    Ethnicity
    African-AmericanAmerican Indian/Native AlaskanAsian/Pacific IslanderCaucasianHispanicMore than oneI choose not to declare



    Military Veteran (select all that apply)
    Not a VeteranRecently Separated VeteranVietnam Era VeteranWar/Campaign/Expedition VeteranArmed Forces Service Medal VeteranI choose not to declare







    Referral Source (select all that apply)
    Employment AgencyCommunity AgencyNewspaper AdOnline ApplicationPark EmployeeJob ServiceCollege RelationsRehireUnion Hall




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