Caspers Construction » Job Openings

Application for Employment
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.
Date of Application
Position(s) applied for
Wage Desired
Referral Source
- Advertisement
- Friend
- Relative
- Walk-In
- Employment Agency

Name
First Middle Last
Home Phone
Cell Phone
List all addresses at which you resided for 3 years prior to date of application.
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long at this address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long at this address?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How long at this address?

Have you been convicted of a felony within this last 7 years?
- Yes
- No
*Conviction will not necessarily disqualify applicant from employment.
If yes, please explain.
State Driver's License Number
Expiration Date
Issuing State
CDL Endorsements
Medical Card?
Expiration Date
List all motor vehicle accidents in the last 3 years. Specify date, nature of accident, and any fatalities or injuries it caused.
List all violations of major vehicle laws other than parking during the last 3 years for which you were convicted or bond was forfeited.
Has your driver's license ever been revoked or denied?
- Yes
- No
If yes, indicate in detail all facts and circumstances.

Give name, address, and phone number of 3 references who are not related to you and are not previous employers.
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Employment Experience
Start with your present or last job.
*List all types of equipment operated including trucks, truck tractors, semi trailers, full trailers, and types of construction equipment. Indicate the nature of work performed and the number of years or months operated.
Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Supervisor
Starting Date
Ending Date
Reason for Leaving
Starting Hourly Rate/Salary
Ending Hourly Rate/Salary
Work Performed and Equipment Operated:
Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Supervisor
Starting Date
Ending Date
Reason for Leaving
Starting Hourly Rate/Salary
Ending Hourly Rate/Salary
Work Performed and Equipment Operated:
Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Supervisor
Starting Date
Ending Date
Reason for Leaving
Starting Hourly Rate/Salary
Ending Hourly Rate/Salary
Work Performed and Equipment Operated:

Applicant's Statement
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision and release Casper's Construction and D-K Contracting Corporation from any and all liability concerning collection and use of information. In accordance with the regulations of the Motor Carrier Safety Administration, the information contained in this application may be used and the applicant's previous employers will be contacted for the purpose of investigating the applicant's safety performance history information. I understand that Nebraska is an at–will employment state. An employee may be fired for any reason so long as it is not discriminatory or retaliatory. However, an employer may not treat protected class members differently than non-protected class members in the terms, conditions and privileges of employment. I understand that this application is not and is not intended to be a contract of employment.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.
Signature of Applicant
Date

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