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RIGgs CONTRACTING
EMpl
OYMENT APPLICATION
Applicant Name *
Date *
Email Address *
Phone Number *
Your Address *
How were you referred to the Company?
Desired Position *
Desired Pay $
Temporary Work
Part-Time
Full-Time
If hired, what day can you start? *
What days and hours are you available for work?
Monday
Morning
Afternoon
Evening
Tuesday
Morning
Afternoon
Evening
Wednesday
Morning
Afternoon
Evening
Thursday
Morning
Afternoon
Evening
Friday
Morning
Afternoon
Evening
Saturday
Morning
Have you applied to and/or worked for this company before? *
Yes
No
If yes, please explain
If hired, will you have reliable transportation to and from work? *
Yes
No
If hired, would you be able to present evidence of your US citizenship or proof of your legal right to work in the United States? *
Yes
No
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? *
Yes
No
If No, please describe what functions cannot be performed
Have you ever been convicted of a Felony? *
Yes
No
If yes, please describe the crime – state the nature of the crime(s), when and where convicted, and disposition of the case.
EDUCATION, TRAINING, & EXPERIENCE
High School (School Name & Location)
Graduate
Yes
No
College/University (School Name & Location)
Years Completed
Graduate
Yes
No
Degree / Diploma Earned
Vocational (Name, Location & Completion Status)
Other
ADDITIONAL INFORMATION
Do you speak, write, or understand any foreign language? *
Yes
No
If yes, describe which language(s) and how fluent of speaker you consider yourself to be.
Do you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us?
Yes
No
If yes, please explain
EMPLOYMENT HISTORY
Are you currently employed? *
Yes
No
If you are currently employed, may we contact your current employer?
Yes
No
Below, please describe past and present employment positions. Please account for all periods of unemployment.
Name of Employer
Currently Employed Here?
Yes
No
Supervisor
Address
Phone Number
City/State/Zip
Business Type
Position & Duties
Length of Employment (Years & Months)
Reason for leaving
May we contact this employer for reference?
Yes
No
Name of Employer
Supervisor
Address
Phone Number
City/State/Zip
Business Type
Position & Duties
Length of Employment (Years & Months)
Reason for leaving
May we contact this employer for reference?
Yes
No
Name of Employer
Supervisor
Address
Phone Number
City/State/Zip
Business Type
Position & Duties
Length of Employment (Years & Months)
Reason for leaving
May we contact this employer for reference?
Yes
No
REFERENCES
Reference 1 (Name, Phone Number, Occupation, Years Acquainted)
Reference 2 (Name, Phone Number, Occupation, Years Acquainted)
Reference 3 (Name, Phone Number, Occupation, Years Acquainted)
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company. I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company. I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure.
Type Name Here to Sign *
Date *
