Complete all blanks. Attach a resume if available.

To submit a copy of your resume:

Personal Information

First name *

Middle

Last name *

PRESENT Street address *

City *

State *

Zip *

PREVIOUS Street address

City

State

Zip

Social Security number

Phone number *

Email address *

Interest

Position you are applying for:

Salary desired

How did you hear about this position?

When are you available to start?

Have you ever applied with this company?

Yes

No

Have you ever been employed by this company?

Yes

No

If yes, provide dates, positions and location information.

List any friends/relatives working for us and their relationship to you.

Skills

List any special skills you feel are applicable to the job you are applying for (i.e. licenses, certifications, special training, computer skills, etc.)

Education

High School

Graduate

Yes

No

Years completed

9

10

11

12

Diploma or GED

Diploma

GED

College, University, Tech School 1

City/State

Major

Degree earned

Date earned

College, University, Tech School 2

City/State

Major

Degree earned

Date earned

Military

Have you ever served in the Armed Forces? (If yes, please provide the following information.)

Yes

No

If yes, please provide the following information.

From

To

What branch?

Rank at discharge

Reason for leaving

List your duties, training and duty station.

Employment History

List your three most recent employers (current or most recent first).

Employer 1

Position

Employed from

To

Name in records

Supervisor name & title

Employer street address

Employer city/state

List major responsibilities

Reason for leaving

Beginning pay

Ending pay

Employer 2

Position

Employed from

To

Name in records

Supervisor name & title

Employer street address

Employer city/state

List major responsibilities

Reason for leaving

Beginning pay

Ending pay

Employer 3

Position

Employed from

To

Name in records

Supervisor name & title

Employer street address

Employer city/state

List major responsibilities

Reason for leaving

Beginning pay

Ending pay

References

Please provide (3) PROFESSIONAL references (no friends or family.) These references should be able to attest to your work performance.

Reference 1

Name

Relationship

Length of relationship

Phone

Reference 2

Name

Relationship

Length of relationship

Phone

Reference 3

Name

Relationship

Length of relationship

Phone

Convictions

Have you ever pleaded to or been found guilty of a felony or misdemeanor?

Yes

No

If yes, explain below. Include date(s) of incident.

Convictions are not an absolute bar to employment and will be considered only if there is a substantial relationship to the circumstances of the particular job or bondability is an issue. Failure to disclose any and all felony or misdemeanor convictions may be considered falsification of the application and be a bar to your employment. Applicants are not required to disclose expunged or sealed records of conviction or arrest.

Drivers License

To comply with the Federal Immigration Reform and Control Act, EMPLOYER requires all new hires to show proof of their eligibility to work in the United States (Form I-9). Failure to produce the required documents will cause EMPLOYER to withdraw its job offer and terminate an individual's employment. (Most common documents to provide are a copy of your driver’s license and social security card, but there are other options.)

Print as it appears on your driver's license:

Your name

Driver's license number

State issued by

Date of birth

Expiration

License is valid & unrestricted

Yes

No

Do you have a CDL?

Yes

No

Previous Driver Licenses Information List any other licenses/permits you may have held in different states in the past three years.

State issued by

Driver's license #

Name as it appeared on license

In the past three years have you worked in a position that required a CDL?

Yes

No

In the past three years, have you applied for a position that required a CDL, but were not hired for that position?

Yes

No

If you answered yes, have you tested positive on any Federal DOT pre-employment drug or alcohol test?

Yes

No

Have you refused to take a Federal DOT pre-employment drug or alcohol test?

Yes

No

If you answered YES to either of the questions above, you are required to provide documentation that you have successfully completed the return to-duty process required by Part 40 Subpart O.

I agree that evidence of driving while under the influence of alcohol or illegal drugs during my employment will be grounds for immediate termination without recourse. I hereby authorize the release and delivery of all motor vehicle driving records relating to the undersigned, including but not limited to personal information, to Fox Structures, Inc. and/or its representative and its insurance agent. This authorization will remain in effect during the course of my employment. A photocopy of this executed authorization shall be as valid as an original. *

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Drug & Alcohol Testing

I understand that participation in the anti-drug and alcohol program is a requirement of employment and therefore, a condition of employment. Employees who work for Fox Structures, Inc. will be deemed to have implied their consent to cooperate in its efforts to maintain a workplace free from the effects of alcohol and controlled substances. This does not alter the at-will employment relationship between the Company and its employees. It is not meant to create a contract or expectation of future employment and is merely one condition of continued employment.

I understand that I may undergo pre-employment testing and testing throughout my employment for controlled substances, illegal drugs and alcohol. I understand that the results of testing will be used in determining my eligibility for hire and continued employment. A photocopy of this executed authorization shall be as valid as an original. *

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Agreement

- I certify that answers given herein are true and complete to the best of my knowledge.

- I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment.

- I understand that as part of the processing procedure for my employment application an investigative report regarding my criminal record, including misdemeanors and traffic violations, may be completed. I also understand that if I am denied a job based on information included in that report, I will be supplied with a copy of that report.

- I hereby understand and acknowledge that unless otherwise defined by applicable law, any employment relationship with this organization would be of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

- In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in denial of employment or discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

- I understand that as a condition of employment, I may have to undergo a drug/alcohol test and/or a physical examination.

- I agree that if I become indebted to the Company, I will be responsible for repaying the total owed upon termination from the Company. If I do not repay the sum prior to my final paycheck being received, the money owed will be deducted from my pay.

- This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period must apply again. *

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Date completed *

A photocopy of this executed authorization shall be as valid as an original.