Date:

First Name (required):

Middle Name:

Last Name (required):

Street Adress:

Apt No:

City:

State:

Zip Code:

Position Applying For (hold control key to select multiple):
CDL Truck driverGeneral LaborPile DriverPile Driver WelderPile Driving Crane Operator (NCCCO LBC Certified)Estimator/ Project ManagerOther

Years of Experience:

Salary Desired:

Willing to work out of town?:
YesNo

Willing to work overtime?:
YesNo

Are you 18 or older?:
YesNo

Telephone Number (required):

E-mail Address:

Safety Council

Do you have a current Safety Council Card?
YesNo

If yes, list what site specific classes and what site specific training you have?

From which Safety Council?

Do you have a TWIC card?
YesNo

Education

Highest level achieved:
High School(GED) High SchoolTrade SchoolBusiness SchoolVocational TrainingMilitary TrainingCollege/University

Highest grade completed:
9101112

Did you graduate:
YesNo

Name and address of high school:

List any other training or skills:

The job for which you are applying may require walking, climbing, bending, twisting, reaching, and lifting 50 pounds plus or minus. Are you capable of performing the functions of the job for which you are applying with or without reasonable accommodations?
YesNo

Have you ever been discharged from a position for making threats, fighting, or any incidents involving violence?
YesNo

Are you legally authorized to work in the United States of America? (Proof of applicants legal right to work in the USA will be required after being (hired)
YesNo

Employment History

Company 1 Name:

From:

To:

Salary:

Position Held:

Phone Number:

Supervisors Name:

Reason for leaving?

Company 2 Name:

From:

To:

Salary:

Position Held:

Phone Number:

Supervisors Name:

Reason for Leaving?

Company 3 Name:

From:

To:

Salary:

Position Held:

Phone Number:

Supervisors Name:

Reason for Leaving?

Reference 1:

Occupation:

Phone Number:

Years Known:

Reference 2:

Occupation:

Phone Number:

Years Known:

Reference 3:

Occupation:

Phone Number:

Years Known:

I understand that Piling, Inc. is an equal opportunity employer and will not discriminate in any phase of employment. This application is not an offer of employment or contract. Any employment with Piling, Inc. is on an at-will basis. If hired, I or company may terminate the employment relationship at any or without notice or cause.

I certify that the information given in this employment application is true and complete to the best of my knowledge. By my signature, I give full author Piling, Inc. to verify any and all information for the purposes of employment. If further authorize Piling, Inc. to contact my previous employers for employ references. I release Piling, Inc. from any liability associated with contacting my previous employers.

In accordance with the requirements of section 1681(b)(2) of Title 15 of the United States Code, commonly known as the Consumer Credit Protection. Company hereby notifies me that it may obtain a report concerning my credit history and criminal records for employment purposes. Before taking an action based in whole or in part upon such a report, the Company will provide me with a copy of the report and a description of my rights as a consumer the Consumer Credit Protection Act. By signing below, I acknowledge that I consent, voluntarily and without coercion and duress, to procurement of a report detailing my credit history and criminal record and acknowledge my understanding of the terms of this disclosure. I further release Piling, Inc. from liability in connection with the obtaining of such reports for the purpose provided herein.

I accept these terms:
YesNo

Date:

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