ND CONTRACTORS LICENSE #36713 CLASS A
701-751-3230

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Application For Employment

Application for Employment

Step 1 of 6 - Personal Information

16%

Basic Info
Name*
First Middle Last
Other Name(s) Used
First Middle Last
Home Phone #
Cell Phone #*
Email
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Position Applied For*
Referred By
Salary Desired*

Background Information
Have you ever interviewed with the Company or its affiliates before?*
- Yes
- No
If yes, list date(s), job title(s) & location(s)*
Have you ever been employed by the Company or its affiliates before?*
- Yes
- No
If yes, list date(s), job title(s) & location(s)*
Do you have any relatives employed by the Company or its affiliates?*
- Yes
- No
If yes, list date(s), job title(s) & location(s)*
Are you at least 18 years old?*
- Yes
- No
If no, do you have a work permit?*
- Yes
- No
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation)*
- Yes
- No
Are you willing to travel for work?*
- Yes
- No
If yes, what percent? Travel may be daily or weekly.*
Do you have the following:
- Driver’s License
- CDL
- OSHA-10 Certification
Are you looking for full time employment?*
- Yes
- No
What hours are you available?*

Education
Highest Grade Completed - Highschool:
- 9
- 10
- 11
- 12
Highest Grade Completed - College:
- 1
- 2
- 3
- 4
Highest Grade Completed - Graduate Studies:
- 1
- 2
- 3
- 4
High School Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Major Studies
Degree, Diploma, License or Certificate
College/University Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Major Studies
Degree, Diploma, License or Certificate
Vocational, Business, Other
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Major Studies
Degree, Diploma, License or Certificate
List Any Professional Designations/Equipment Certifications:
Other Special Knowledge, Skills or Qualifications

Employment History

List all employments for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.
Employer Name
Supervisor Name
Supervisor Phone #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Employed From
MM slash DD slash YYYY
Employed Until
MM slash DD slash YYYY
Starting Salary
Ending Salary
May We Contact?
- Yes
- No
Reason for Leaving
Duties & Responsibilities
Employer Name
Supervisor Name
Supervisor Phone #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Employed From
MM slash DD slash YYYY
Employed Until
MM slash DD slash YYYY
Starting Salary
Ending Salary
May We Contact?
- Yes
- No
Reason for Leaving
Duties & Responsibilities
Employer Name
Supervisor Name
Supervisor Phone #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Employed From
MM slash DD slash YYYY
Employed Until
MM slash DD slash YYYY
Starting Salary
Ending Salary
May We Contact?
- Yes
- No
Reason for Leaving
Duties & Responsibilities

General
May we contact your current employer for references?*
- Yes
- No
If hired, will you be able to work overtime?*
- Yes
- No
Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation? (Including working on or near schools and daycares.)*
- Yes
- No
Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or seals by court? (A yes response does not automatically disqualify your application.)*
- Yes
- No

Certification & Authorization

The above information is true and correct. I understand that, in the event of my employment by Straightway Construction, Inc. (SCI), I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize SCI to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to SCI and will hold SCI and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize SCI to obtain any credit and consumer check.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with SCI is intended to create an employment contract between myself and SCI under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired, my employment will be terminable at will and may be terminated by me or SCI at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing.

I understand that Straightway Construction, Inc. reserves the right to perform a criminal back ground check, DMV check and a pre-employment drug screen as a condition of my employment.

If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.

I hereby acknowledge that I have read and agree to the above statements.
Signature*
Today's Date*
MM slash DD slash YYYY
File
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Accepted file types: jpg, doc, docx, pdf, Max. file size: 256 MB, Max. files: 5.
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