Employment Application Form

Name:*

First NameMiddle NameLast Name

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail Address:

Phone Number:*

Area CodePhone Number

Position Desired:*

Date Available*

MonthDayYear

Desired Salary:

Have you ever worked for T B Landmark before?*

Have you ever applied to T B Landmark before?*

Are you under 18 years of age?*

Are you eligible to work in the US?*

Do you have transportation to and from work?*

Are you able to travel if the job requires it?*

Do you require any special accomodations to perform the essential function of your job?*

Please explain:

What days of the week are you available to work?*

Are there any hours, shifts or days that you are unable to work?

Have you been convicted of a felony in the last five years?*

Please provide details:

How were you referred to us?*

Upload Resume:

Upload a File

Optional

Please indicate the highest level of education completed.*

Company Name*

Phone Number*

Area CodePhone Number

Reason for Leaving

Supervisor Name

First NameLast Name

Can we contact them?*

Start Date

MonthDayYear

To

MonthDayYear

Salary

Duties/Responsibilities

Company Name*

Phone Number*

Area CodePhone Number

Reason for Leaving

Supervisor Name

First NameLast Name

Can we contact them?*

Start Date

MonthDayYear

To

MonthDayYear

Salary

Duties/Responsibilities

Company Name*

Phone Number*

Area CodePhone Number

Reason for Leaving

Supervisor Name

First NameLast Name

Can we contact them?*

Start Date

MonthDayYear

To

MonthDayYear

Salary

Duties/Responsibilities

Name:*

First NameLast Name

Phone Number*

Area CodePhone Number

Years Known:*

Relationship:*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Name:*

First NameLast Name

Phone Number*

Area CodePhone Number

Years Known:*

Relationship:*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Name:*

First NameLast Name

Phone Number*

Area CodePhone Number

Years Known:*

Relationship:*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Please list any additional skills or training that are relevant to the job you are applying for.

NOTE TO APPLICANTS: We comply with the American with Disabilities Act of 1990. During the interview process you may be asked questions concerning your ability to perform job related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subject to the same medical questionnaire and/or examination and all information will be confidential and in separate files.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. T B Landmark Construction does not discriminate on the basis of race, color, national origin, sex, religion, disability, or age in its programs, activities or employment practices. We assure you that your opportunity for employment depends solely on your qualifications.

CERTIFICATION AND RELEASE: I certify that I have read and understood the foregoing questions and statements. I certify that my answer are true and complete to the best of my knowledge. I understand that any false information, omissions or misrepresentations of fact called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus to verify any of this information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to a drug test to detect the use of illegal drugs prior to and at any time during employment.

Employment Application

Education

Employment History

Most Recent Employer

Second Most Recent Employer

Third Most Recent Employer

References

Reference 1

Reference 2

Reference 3

Job Skills & Training