Employment Application
1535 S Quarterhorse Lane Camp Verde, AZ 86322 Phone (928) 567-3539 | Fax (928) 567-6171
McDonald Bros Construction is an Equal Opportunity Employer of qualified individuals.
FAILURE TO FULLY COMPLETE THE INFORMATION REQUESTED ON THIS APPLICATION WILL ELIMINATE YOU FROM FURTHER CONSIDERATION
PERSONAL INFORMATION
Name (Last, First, Middle Initial)
Driver license number, state and classification:
Present Address
Apt. No.
City
State
Zip Code
Phone No.
Are you a U.S. citizen or an alien authorized to work in the United States?YesNo
In case of an emergency, notify
Address
Phone
DESIRED EMPLOYMENT
Position Applying for
Date you can start
Rate Expected
Are you seekingFull TimePart TimeSummerSeasonal
EDUCATION
SCHOOL LEVEL
High School
Name and Location of School
Major/Minor
Degree Received
College
Trade School
Military School
LEGAL BACKGROUND RECORD
Have you ever been convicted of a felony crime?YESNO
What was your charge?
Has your driver's license ever been revoked?YESNO
If YES, when and why?
GENERAL
Equipment—Please choose an option—BackhoeLoaderExcavatorTrencherDump TruckLasersBladeOther
Please list other equipment
List years of Experience on above
SPECIAL SKILLS
Please list any additional information that would be helpful in determining employment eligibility
Excavation Experience
lease insert years experience in the boxes below for each division. Explain any other below :
Sewer installWater linesDry utilitiesRock hammerPavingRoadsSeptic installDrainageFootingsRootingsSubdivisionsother
Other areas of expertise
REFERENCES
Please list three personal references (not former employers or relatives)
Name
Years Acquainted
THE FOLLOWING PAGES OF INQUIREY SHOULD ONLY BE FILLED OUT BY DRIVER APPLICANTS AND/OR MECHANICS, IF YOU ARE NOT APPLYING FOR A DRIVING POSITION PLEASE SKIP TO PREVIOUS AND PAST EMPLOYMENT HISTORY
Accident Record for Past 3 years or more (Attach sheet if more space is needed) If none, Write NONE
Last Accident
Dates
Nature of Accident
Fatalities
Injuries
Next Previous
Traffic Convictions/Forfeitures for the Past 3 Years (Other than parking violations) If none, Write NONE
Location
Date
Charge
Penalty
Experience and Qualifications - DRIVER ONLY
Lecense No.
Type
Expiration Date
A. Have you ever been denied a license, permit or privilege to operate a motor vehicle?YESNo
B. Has any license, permit or privilege ever been suspended or revoked? If the answer to A or B is yes, attach statement giving details.YESNo
Driving Experience (if none, write NONE)
Class of Equipment :
Straight Truck
Type of Equipment
Dates (From - To)
Approx No. of Miles
Tractor & Semi-Trailer
Tractor - Two Trailers
Water Truck
Motorcoach - Bus
Other
THIS SECTION IS TO BE COMPLETED BY DRIVER/MECHANIC APPLICANT ONLY.
List States Operated in for Last Five Years
Show special courses or training that will help you as a driver
Which safe driving awards do you hold and from whom?
Past and Previous Employment: (If applying for DRIVER positions all driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code. Applicants to driving a commercial motor vehicle which includes vehicles having a GVRW of 26,001 or more, vehicles designed to transport 15 or passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding, shall also provide an additional 7 years information on those employers for whom the applicant operated such vehicle).
Note: List employers in reverse order starting with the most recent. Add additional sheets as necessary.
PREVIOUS AND PAST EMPLOYMENT HISTORY:
Name of Present or Last Employer
Job Title
Supervisor's Name
May we contact him/her?YESNo
Supervisor's Job Title
Supervisor's Phone
Starting Date
Leaving Date
Sarting Salary/Wage
Final Salary/Wage
Description of Work
Reason for Leaving
All potential employees are subject to a drug screen and depending on the position, driving record check, criminal history review, reference check and any other background check pertaining to the applicant. McDonald Bros. Construction, Inc. is an Equal Opportunity Employer.
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 McDonald Bros. Construction, Inc. to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.)
hereby release employers, schools, health care providers and other persons from all liability in responding to inquires and releasing information in connection with my application.
