Job Application

Position Desired
First Name
Last Name
Social Security Number
Present Address Phone Number
Are you 18 years or older? yesno Are you legally eligible for employment in the U.S.? yesno Have you ever been convicted of a felony in the last 7 years? (a conviction does not automatically preclude employment) yesno If yes, please explain. Date you can start
Salary Desired
Are you employed now? yesno If so, may we contact your current employer? yesno Have you ever applied for a position at Judds Bros before? yesno Referred by
Grammar School - Name and Location
Grammar School - Number of Years Attended
Grammar School - Did you graduate?
Grammar School - Subjects Studied
High School - Name and Location
High School - Number of Years Attended
High School - Did you graduate?
High School - Subjects Studied
College - Name and Location
College - Number of Years Attended
College - Did you graduate?
College - Subjects Studied
Trade, Business or Correspondence School - Name and Location
Trade, Business or Correspondence School - Number of Years Attended
Trade, Business or Correspondence School - Did you graduate?
Trade, Business or Correspondence School - Subjects Studied
Special skills related to the job for which you are applying
U.S. Military or Naval Service
Rank
Present Membership in National Guard or Reserves
Former Employers - list Name and Address of previous employers as well as Position, Salary, Reason for Leaving, the Name and Phone Number of your supervisor, and Start and End dates of employment for each List your references (do not include relatives). Give the name, address, phone number (or business name), and years acquainted. Has anyone explained the physical requirements of this job? yesno Are you able to perform the essential functions of this position with or without a reasonable accomodation? yesno If accommodations are necessary, what type of accommodation wouuld be necessary for you to perform the position? I certify that all the information submitted by me 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 regulations, and agree that my employment and compensation can be terminated, 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, and with or without notice, at any time without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. I authorize Judds Bros. Construction Co. to contact prior employers and references, unless otherwise noted on this application.