At Smith & Company, Inc., we are always accepting applications for the following positions:

• Roller Operator
• Heavy Equipment Mechanic
• Backhoe Operator
• Bulldozer Operator
• Administrative/Accounting
• Skilled/Unskilled Laborers
• Concrete Finisher
• Dragline Operator
• Estimator
• Heavy Equipment Operator

If you are interested in any of these positions, please fill out the employment
application below and click the submit button at the bottom when you are finished.

APPLICATION FOR EMPLOYMENT
REGION:
POSITION: SALARY DESIRED:
NAME:
ADDRESS:
Have you filed an application here before? Yes No
If so, date of employment:
Are you on layoff, subject to recall? Yes No
Can you travel if the job requires it? Yes No
List the names of friends/relatives who work here:
Have you been convicted of a crime in the last 7 years?
(An affirmative answer to this question does not constitute bar to employment)
Please explain if Yes: 		Yes No
Are you a veteran of U.S. Military Service? If yes, Yes No

EDUCATION
High School: /
Years completed: Diploma? GED?
College: /
Years completed: Degree?
Technical/Trade School: /
What type of special training did you receive?
Comments/Special Qualifications:
Employees are hired without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status. The purpose for this data record is to comply with government record keeping, reporting and other legal requirements.


EMPLOYMENT HISTORY

Please list your last 3 employers with the last one appearing first.
Dates of employment :

From to

Salary: From to

Job Title:


Reason for Leaving:


Responsibilities:
Employer Name:
Location:

Dates of employment :

From to

Salary: From to


Job Title:


Reason for Leaving:


Responsibilities:
Employer Name:
Location:

Dates of employment :

From to

Salary: From to

Job Title:


Reason for Leaving:


Responsibilities:
Employer Name:
Location:



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