Job Application Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Are you over 18 years of age:* Yes No Sex:* Male Female Driver's License No.Driver's License StateDriver's License Expiration Date Month Day Year Position Desired*Job Cost CoordinatorProduction SupervisorCarpenter Lead ManCarpenter's HelperPlumber/ElectricianDrywall/PainterInsulation InstallerDate you can begin work:* MM slash DD slash YYYY Are you currently employed:* Yes No If so, may we contact your employer?* Yes No List your past three (3) employers, beginning with most recent:CompanyAddressPhoneSupervisor List your past three (3) schools you attended, beginning with most recent:NameYears CompletedDid You Graduate?Major/Degree List three (3) references and their contact information:*NamePhone NumberRelationship To This Person Construction Experience*List any and all experience you have in the construction industry. Please be specific.Pre-Employment Drug Testing Consent*I hereby consent to submit to urinalysis and/or other tests as shall be determined by E & T Contracting in the selection process of applicants for employment, for the purpose of determining the drug content thereof. I agree that WorkPlace Solutions/621 Old Hickory Blvd. Ste G, Jackson, TN may collect these specimens for these tests and may test them or forward them to a certified testing laboratory designated by the company for analysis. I further agree to and hereby authorize the release of the results of said tests to E & T Contracting and their MRO (Medical Review Officer). I further agree to hold harmless the said laboratory and MRO and its agents from any liability arising in whole or part out of the collection of specimens for testing. I have carefully read the foregoing and fully understand the contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document. I agree.I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application will be grounds for dismissal.* I agree.Upload A ResumeMax. file size: 20 MB.CAPTCHANameThis field is for validation purposes and should be left unchanged. Δ
