Employment Application

MCDONALD BROS CONSTRUCTION, INC

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

Name and Location of School

Major/Minor

Degree Received

College

Name and Location of School

Major/Minor

Degree Received

Trade School

Name and Location of School

Major/Minor

Degree Received

Military School

Name and Location of School

Major/Minor

Degree Received

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Has your driver's license ever been revoked?YESNO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 list other equipment

List years of Experience on above

SPECIAL SKILLS

Please list any additional information that would be helpful in determining employment eligibility

REFERENCES

Please list three personal references (not former employers or relatives)

Name

Address

Phone

Years Acquainted

Name

Address

Phone

Years Acquainted

Name

Address

Phone

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

Dates

Nature of Accident

Fatalities

Injuries

Next Previous

Dates

Nature of Accident

Fatalities

Injuries

Traffic Convictions/Forfeitures for the Past 3 Years (Other than parking violations) If none, Write NONE

Location

Date

Charge

Penalty

Location

Date

Charge

Penalty

Location

Date

Charge

Penalty

Experience and Qualifications - DRIVER ONLY

State

Lecense No.

Type

Expiration Date

State

Lecense No.

Type

Expiration Date

State

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

Type of Equipment

Dates (From - To)

Approx No. of Miles

Tractor - Two Trailers

Type of Equipment

Dates (From - To)

Approx No. of Miles

Water Truck

Type of Equipment

Dates (From - To)

Approx No. of Miles

Motorcoach - Bus

Type of Equipment

Dates (From - To)

Approx No. of Miles

Other

Type of Equipment

Dates (From - To)

Approx No. of Miles

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

Address

City

State

Zip Code

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

Name of Present or Last Employer

Address

City

State

Zip Code

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.

Date

Employment Application

MCDONALD BROS CONSTRUCTION, INC

McDonald Bros Construction Inc.

Licensed and Bonded