Employment Application Employment Application Employment Application Personal Information First Name * Last Name * Address * City, State, Zip Code * Date of Birth * Email * Cell Phone Home Phone Employment Desired * Select Full Time Part Time Full or Part Time Referred To Us By Education Grade Completed * Year Completed * GED (if HS not completed) Yes No GED (if no HS diploma) Special Schooling or Certificates Experience Apprentice # of years Engineer # of years Laborer # of years Steel Worker # of years Boilermaker # of years Foreman # of years Millwright # of years Pipefitter # of years Electrician # of years Journeyman # of years Machinist # of years Welder # of years Previous Employers Previous Employer #1 Job Title Date From Date To Rate of Pay Supervisor Supervisor phone number Duties Reason for leaving Previous Employer #2 Job Title Date From Date To Rate of Pay Supervisor Supervisor phone number Duties Reason for leaving Previous Employer #3 Job Title Date From Date To Rate of Pay Supervisor Supervisor phone number Duties Reason for leaving Personal References (other than family members or previous employers) 1st Reference 1st Reference Phone Number 2nd Reference Name 2nd Reference Phone Number 3rd Reference Name 3rd Reference Phone Number Attach Resume Drop a file here or click to upload Choose File Maximum upload size: 268.44MB I understand that Jackson & Jackson Industrial Contractors, 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 Jackson & Jackson Industrial Contractors, 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 authorization to Jackson & Jackson Industrial Contractors, Inc. to verify any and all information for the purposes of employment. If further authorize Jackson & Jackson Industrial Contractors, Inc. to contact my previous employers for employ references. I release Jackson & Jackson Industrial Contractors, 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 Jackson & Jackson Industrial Contractors, Inc. from liability in connection with the obtaining of such reports for the purpose provided herein. I agree to these terms * Yes No Signature Clear If you are human, leave this field blank.