Employment Application

C. W. Roberts Contracting > Employment Application

CWR Employment Application

Step 1 of 15

6%

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*

If under 18, please list age
Sometimes a job may require that we work at night, to avoid heavy traffic, thus creating a safer work environment for our employees.
Can you work nights?*
- Yes
- No
Can you work weekends?*
- Yes
- No
Are you willing to work overtime?*
- Yes
- No
Are you willing to travel out of town with overnight stays?*
- Yes
- No
How did you learn about us?*
- Advertisement
- Employment agency
- Friend
- Relative
- Walk In
- Other
Employment Desired*
- Full Time
- Part Time
- Full or Part Time
When are you available to start work?*
Do you speak or write any foreign languages?*
- Yes
- No
If so, what language(s)?*

Are you a citizen of the United States?*
- Yes
- No
If no, are you authorized to work in the U.S.?*
- Yes
- No
Have you ever worked for this company?*
- Yes
- No
If so, when?*
Have you ever been convicted of a felony?*
- Yes
- No
If yes, explain.*
Have you ever had an adjudication withheld, or nolo contendere?*
- Yes
- No
If yes, explain.*

EDUCATION
High School Name
High School Address
Street Address City State ZIP Code
From
Date Format: MM slash DD slash YYYY
To
Date Format: 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
Date Format: MM slash DD slash YYYY
To
Date Format: 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
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Degree earned

Do you have a driver's license?*
- Yes
- No
Driver's license number*
State of Issue*
Expiration Date*
Date Format: MM slash DD slash YYYY
Drivers License Type*
- Operator
- Commercial (CDL)
- Chauffeur
Do you have reliable transportation to work?*
- Yes
- No
Have you had any accidents during the past three years?*
- Yes
- No
How many?*
Have you had any moving violations during the past three years?*
- Yes
- No
How many?*

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
Date Format: MM slash DD slash YYYY
Employer #1 End Date
Date Format: 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
Date Format: MM slash DD slash YYYY
Employer #2 End Date
Date Format: 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
Date Format: MM slash DD slash YYYY
Employer #3 End Date
Date Format: 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:

EEO SURVEY
We consider applicants for all positions without regard to race, color, sex, national origin, religion, age, marital status, genetic information status, pregnancy, disability, veteran status, sexual orientation, gender identification, transgender, or any other legally protected class. The information requested on this form is collected by the company to comply with Affirmative Action/Equal Employment Opportunity and other federal laws and regulations. This information is considered confidential and will not be a part of your official application for employment.
Position title for which you are applying:*
Gender*
- Male
- Female
Date of Birth*
Date Format: MM slash DD slash YYYY
Race*
- Hispanic or Latino
- White (Not Hispanic or Latino)
- Black or African American
- Native Hawaiian or Other Pacific Islander
- American Indian or Alaska Native
- Asian
- Two or More Races
You are invited to identify yourself as a disabled veteran, veteran of the Vietnam Era, or disabled individual. This information is voluntary and will be kept confidential. Refusal to provide it will not subject you to any adverse treatment. The information will be used for affirmative action purposes. It is not used or considered in the selection process and is filed separately from the application. The Vietnam Era is defined by Federal Regulations as August 5, 1964 to May 7, 1975.
Veteran Status: Which applies to you?
- Disabled Veteran: A Veteran entitled to compensation for disability rated at 30% or more, or a person who is discharged or released from active duty because of a service connected disability.
- Recently Separated Veteran: A Veteran who served on active duty in the U.S. military, ground, naval or air service during the three-year period beginning on the date of such veteran’s discharge or release from active duty.
- Active Duty Wartime or Campaign Badge Veteran: A Veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized by the Department of Defense.
- Armed Forces Service Medal Veteran: A Veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
- I am a protected veteran, but I choose not to self identify the classifications to which I belong.
- I am not a protected veteran.
To qualify as a Disabled Individual, you must: 1. Have a physical or mental impairment which substantially limits one or more life activities (including employment); 2. Have a record of such impairment; or 3. Be regarded as having such impairment.
Do you qualify as such an individual?*
- Yes
- No
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.
Name
This field is for validation purposes and should be left unchanged.

Corporate Office

3372 Capital Circle NE
Tallahassee, Florida 32308
Phone: (850) 385-5060

info@cwrcontracting.com

Corporate Hours

Our corporate office is open the following times and we look forward to serving you.

Monday-Friday: 8 a.m. to 5 p.m.
Saturday and Sunday: Closed

Plant Facility Hours

Our plant facilities are open the following times. Contact the site office for details.

Monday-Friday: 7 a.m. to 5 p.m.
Other times call to schedule.

Work With Us

Bid Opportunities
Subcontractors and Vendors
Careers

Our Services
Projects
Contact Us
Disclaimer
Privacy Policy

Our Benefits Include:
Health and Dental Insurance
Life, Accidental Death and Dismemberment Insurance
Supplemental Life Insurance
Vision Insurance
Short and Long-term Disability Insurance
Accident Insurance
Critical Illness Insurance
Cancer Insurance
Hospital GAP Insurance
401k Retirement Savings Plan
Verizon Wireless Cell Phone Discounts
Vacation, Holiday, and Sick Pay
Employee Assistance Program
Payroll Direct Deposit
Family and Medical Leave

*Employees are eligible for insurance benefits on the first of the month following 60 days of employment.
*Employees are eligible to enroll in the 401k Retirement Savings on either January 1 or July 1, following one year of service.

Employment Application

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.