8060 Park Drive, P.O. Box 185 • Willow RiverMN55795 • (218) 372-4067
An Equal Opportunity Employer
APPLICATION FOR EMPLOYMENT
Mlaskoch Excavating & Utility is an equal employment opportunity employer and will not discriminate against any applicant or employee on any grounds protected under federal, state, or local law, including race, color, creed, religion, age, sex, sexual harassment, national origin, ancestry, marital status, disability, disability related to pregnancy or childbirth, affectional or sexual preference, membership or activity in any local commission created for the purpose of dealing with discrimination, or status regarding public assistance, membership or non-membership in any labor organization, or any other characteristic protected under federal, state or local law. None of the questions in this application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preference, or discrimination based upon non-job-related information or protected characteristics.
Mlaskoch Excavating & Utility is a mobile contractor. This means that we travel throughout the United States to where our awarded work brings us on a regular basis. All employees travel as part of their employment at Mlaskoch Excavating & Utility and may be out-of-town or out-of-state for long periods of time.
Personal Information
Name: Date of Application:
Address:
Street Apt # City State Zip Code
Telephone: Home: Cell:
Position(s) you are seeking: Date you can start:
Desired Wage or Salary:How did you learn about us?
Have you worked for us before? Yes No Do you hold a valid and current driver’s license? Yes No
Is your license a Commercial Driver’s License (CDL): Yes No Driver’s License Class: A B C D
Have you ever worked in a position similar to the one for which you are applying? Yes No
List experience in using tools or equipment which might be helpful in this position?
Do you have the right to work in the United States? Yes No
If no, explain:
Have you ever been convicted of a felony in the past seven years? Yes No
If yes, please explain fully. Note: The existence of a criminal record does not create an automatic bar of employment:
Are you available to work at any time of the day or week as needed? Yes No
If not, explain limitation:
Education/Training
School Name (Start with most recent) / Program/Course / Number of Years Attended / Did you Complete Course/ / / Yes / No
/ / / Yes / No
/ / / Yes / No
Work Experience
Start with the most recent. Include any job-related military service and volunteer activities.
You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
Employer Name: /Address: /
Supervisor Name: /
Business Telephone Number: /
Job Title/Position: /
Dates Employed: / From: / To:
Duties: /
Reason for Leaving? /
Employer Name: /
Address: /
Supervisor Name: /
Business Telephone Number: /
Job Title/Position: /
Dates Employed: / From: / To:
Duties: /
Reason for Leaving? /
Employer Name: /
Address: /
Supervisor Name: /
Business Telephone Number: /
Job Title/Position: /
Dates Employed: / From: / To:
Duties: /
Reason for Leaving? /
Work Experience (Continued)
Employer Name: /Address: /
Supervisor Name: /
Business Telephone Number: /
Job Title/Position: /
Dates Employed: / From: / Dates Employed:
Duties: /
Reason for Leaving? /
Comments: Include explanation of any gaps in employment:
Please indicate any employers who cannot be contacted and reason:
I hereby certify that I have read and understand all of this application. I certify that this application was completed by me and is submitted solely for the purpose of seeking employment. By my signature below, I promise that the information provided in this employment application (and in any related documentation or interview) is true and complete, and I understand that any false or misleading information or significant omissions my disqualify me from further consideration for employment and may lead to my dismissal from employment, if discovered at a later date. I agree to immediately notify Mlaskoch Excavating & Utility, if I should be convicted or plead guilty to any crime while my job application is pending, or during my period of employment if hired by Mlaskoch Excavating & Utility
I authorize any person, school, organization, current employer (except as previously noted), or prior employer named in the application form (or related documentation to interview) to provide Mlaskoch Excavating & Utility, with any information and opinion requested by Mlaskoch Excavating & Utility, in connection with my application, and I release such persons, employers and organizations from any legal liability in making such statements.
I understand that I may be asked to demonstrate that I am capable of performing tasks essential to the job with or without reasonable accommodation and that if offered a job, it may be conditioned on the results of a physical examination and drug and alcohol test.
I understand that this application does not create a contract of employment. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted policies of Mlaskoch Excavating & Utility, and that Mlaskoch Excavating & Utility, does not offer contracts, promises or representations related to employment except those contained in applicable collective bargaining agreements. I understand and agree that, if hired, my employment is for no definite period of time, and that Mlaskoch Excavating & Utility, retains the right to terminate me at any time for any reason not prohibited by law and that I have the right to resign at any time for any reason, and that these mutual rights constitute the employer's at-will policy. I understand that no person is authorized to change any of the terms mentioned in this employment application.
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Applicant’s Signature Date
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Employment Application - General Date: 3/9/2009