RamJack of West Virginia Application for Employment



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Drug-Free Workplace ~ Application for Employment
(Pre-Employment Questionnaire) (An Equal Opportunity Employer)

* Denotes Required Fields

Position Applied for:		Click for description of positions.
*Last Name:
*First Name:
Middle Name:
*Address:
*City, State, Zip:
*Email:
*Telephone:
Social Security Number:
If necessary what is the best time to reach you at home?
Yes No Are you 18 years or older?
Yes No Are you employed now?
Yes No Have you ever submitted an application here before?
Yes No Have you ever been employed here before?
	If yes, Date:
*Yes No Are you legally eligible for employment in this country?
Date you are available for work?
Desired Wage Range?
Yes No Will you travel if your job requires you to?
Yes No Can you meet the attendance requirements for the position you are applying for?
Yes No Will you work overtime if required?
	If no, please explain:
Type of employment desired: Full Time Part Time Seasonal Temporary
Yes No Have you ever been bonded?
*Yes No Have you ever Pled “Guilty” or “No Contest” to or been convicted of a crime?
	If yes please explain, Give dates an details:
*Yes No Do you have a valid drivers license?
Drivers License Number:

*Educational Background
	Name and Location	# of Years	Did you Graduate?
Elementary School			Yes No
Middle School			Yes No
High School			Yes No
College			Yes No
Trade, Business or Correspondence School			Yes No
Special Skills


*Former Employers (List below the last three employers, starting with the most recent)
1.	Name of Employer
	Address
	City, State, Zip
	Date	From to
	Wage	Start End
	Position
	Reason for Leaving
	Immediate Supervisor
	Telephone
	Yes No May we contact them for a reference?

2.	Name of Employer
	Address
	City, State, Zip
	Date	From to
	Wage	Start End
	Position
	Reason for Leaving
	Immediate Supervisor
	Telephone
	Yes No May we contact them for a reference?

3.	Name of Employer
	Address
	City, State, Zip
	Date	From to
	Wage	Start End
	Position
	Reason for Leaving
	Immediate Supervisor
	Telephone
	Yes No May we contact them for a reference?

List any additional information you would like us to consider:

*References Please list three-that you are not related to, whom you have known for at lease one year.
1.	Name:
	Telephone:
	Years Acquainted:

2.	Name:
	Telephone:
	Years Acquainted:

3.	Name:
	Telephone:
	Years Acquainted:

I certify that all the information submitted on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and , if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company’s rules and regulation, and I agree that my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated with or without cause, and with or without cause, and with or without notice, at any time, at either my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause.
I understand that this application remains current for only 30 days. At the conclusion of the time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in the application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question of the application is used for the purpose of limiting or excusing any application from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and the federal immigration laws require me to complete an I-9 Form in this regard.

DO NOT SUBMIT UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT!!!

*Yes No
I CERTIFY THAT I HAVE READ THIS, FULLY UNDERSTAND IT AND ACCEPT ALL TERMS OF THE FOREGOING APPLICANT STATEMENT.

We accept VISA, MasterCard and American Express.

Moran Construction Address and Contact Information

View the RamJack ICCES Evaulation Enter PFC-5996