Employment Application

CWR Employment Application

Step 1 of 15

Please complete the following information:
Job Location*
Position Applied For*
Last Name*
First Name*
Middle Initial
Address*
Street Address City State ZIP Code
Telephone*
Email Address*

EDUCATION
High School Name
High School Address
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Diploma?
- Yes
- No
- GED

College Name
College Address
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Degree earned

Business or Trade School Name
Business or Trade School Address
Street Address City State ZIP Code
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Degree earned

REFERENCES

Please list three professional references.
Reference #1 Full Name*
Reference #1 Relationship*
Reference #1 Company*
Reference #1 Phone*
Reference #1 Address*
Street Address City State ZIP Code

Reference #2 Full Name*
Reference #2 Relationship*
Reference #2 Company*
Reference #2 Phone*
Reference #2 Address*
Street Address City State ZIP Code

Reference #3 Full Name*
Reference #3 Relationship*
Reference #3 Company*
Reference #3 Phone*
Reference #3 Address*
Street Address City State ZIP Code

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
PREVIOUS EMPLOYMENT
Previous Employer #1 Name
Previous Employer #1 Phone
Previous Employer #1 Address
Street Address City State ZIP Code
Previous Employer #1 Job Title
Previous Employer #1 Supervisor
Previous Employer #1 Starting Pay Rate
Previous Employer #1 Ending Pay Rate
Employer #1 Start Date
MM slash DD slash YYYY
Employer #1 End Date
MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
List the responsibilities, duties performed, skills used or learned, advancements or promotions while you worked at the company.

Previous Employer #2 Name
Previous Employer #2 Phone
Previous Employer #2 Address
Street Address City State ZIP Code
Previous Employer #2 Job Title
Previous Employer #2 Supervisor
Previous Employer #2 Starting Pay Rate
Previous Employer #2 Ending Pay Rate
Employer #2 Start Date
MM slash DD slash YYYY
Employer #2 End Date
MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
List the responsibilities, duties performed, skills used or learned, advancements or promotions while you worked at the company.

Previous Employer #3 Name
Previous Employer #3 Phone
Previous Employer #3 Address
Street Address City -- Select State -- ZIP Code
Previous Employer #3 Job Title
Previous Employer #3 Supervisor
Previous Employer #3 Starting Pay Rate
Previous Employer #3 Ending Pay Rate
Employer #3 Start Date
MM slash DD slash YYYY
Employer #3 End Date
MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
List the responsibilities, duties performed, skills used or learned, advancements or promotions while you worked at the company.

PLEASE READ CAREFULLY
APPLICATION FORM WAIVER

In exchange for the consideration of my job application by C.W. Roberts Contracting, Inc. (hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of C.W. Roberts Contracting, Inc., or otherwise to change in any respect the employment-at- will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President/General Manager of the Company. Both the undersigned and C.W. Roberts Contracting, Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include a reduction in benefits.
I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract. I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.
I certify that I have received a written notification that the Company may obtain a consumer report or reports on me. I authorize this Company to obtain such a report or reports for use in connection with my application for employment and for other employment-related reasons. If hired, this authorization shall remain on file and serve as ongoing authorization for procurement of employment-related consumer reports at any time during my employment. I understand that the term “consumer report” includes, but is not limited to, credit checks, criminal background checks, Department of Motor Vehicle reports, and investigative consumer reports. I authorize the Company to conduct electronic inquiry related to my background, including review of all social networking sites and to make adverse decisions as a result of such inquiries. I further understand that the term “investigative consumer report” means a report in which information on my character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with my neighbors, friends, or associates, or with others with whom I am acquainted or who may have knowledge concerning any such items of information.
I further understand that my employment with the Company shall be probationary for a period of (90) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party. This Company provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, pregnancy, disability, or any other protected status. We assure of my job application by C.W. Roberts Contracting, Inc. (hereinafter called “the Company”), I agree that:
Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of C.W. Roberts Contracting, Inc., or otherwise to change in any respect the employment-at- will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President/General Manager of the Company. Both the undersigned and C.W. Roberts Contracting, Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include a reduction in benefits.
Acknowledgment and Agreement:

CWR Employment Application

Step 1 of 15

Please complete the following information:

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

APPLICATION FORM WAIVER

EEO SURVEY

This information is for compliance reporting only. It will be removed from your application prior to review. It is not considered in the employment process.