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SERVICES
ABOUT
CONTACT

Phone | 435-259-1517
Foreman | 435-260-2963

email us

Contact Us

Name:

Have you used any other legal names?

Yes

No

List any other names used:

Other Names:

Phone:

Email:

Social Security #:

Home Address:

Apt, Ste, Floor, or Room:

City:

State /Province:

Zipcode:

How long have you resided at this address?

Employment Information:

NEW EMPLOYMENT INFORMATION:

Desired Position, Department, or Type of Work:

Do you have a relative(s) working for FEC?

Yes

No

If YES, list name(s) and relationship:

Are you 18 years of age or older?

Yes

No

Date you would be available to work:

Do you have the ability to work overtime and/or travel out of town, if required?

Yes

No

If no, please explain:

Valid Driver's License #:

Commercial Driver's License (CDL)

Class A

Class B

None

Are you a citizen of the U.S. or do you have the legal right to be employed in the United States?

Yes

No

Are you subject to a non-compete, non-disclosure or confidentiality agreement, or any other type of agreement with any current or former employer(s) or organization(s) which would limit your ability to work for our company?

Yes

No

If yes, please explain:

Work History:

PAST EMPLOYMENT HISTORY:

Past Employment Description:

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, provide company name and supply business references.

Have you ever been employed by Flasher Equipment Company?

Yes

No

If yes, provide department and position:

Previous Employer #1:

Employer #1 Address:

City:

State/Province:

Zipcode:

Employer Phone:

Nature of Business

Name and title of last supervisor:

Start Date:

End Date:

Starting Pay:

Ending Pay:

Position Title & Job Description:

Reason for Leaving:

Education:

EDUCATION:

Education Requirement Description:

Education (Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, etc.)

High School Graduate or GED?

Yes

No

If YES, list the name and location of High School or GED institute:

College/Tech/Vocational School:

College/Tech/Vocational School: List up to three schools you have attended.

School #1 Type:

College

Vocational School

Name & Location of School:

Attended Start Date:

Attended End Date:

Date Graduated:

Expected Graduation Date: (Optional)

Type of Diploma or Degree:

Major/Minor Fields of Study:

Licenses/Certificates:

LICENSES/CERTIFICATES:

Licenses/Certificates Description:

If a license or certificate is required or related to the position for which you are applying, complete the below - Examples: Flagger Certification, Traffic Control Technician, Supervisor Traffic Control Technician, Software Certification

Certificate #1: (Optional)

License # (If Applicable)

Issued by / Location of issuing Certificate Issued Expires authority:

Date Issued:

Date Expired: (Optional)

Certificate #2: (Optional)

License # (If Applicable):

Date Issued: (Optional)

Date Expired: (Optional)

Issued by / Location of issuing Certificate Issued Expires authority:

Special Training/Skills/Qualifications:

Do you speak a language other than English?

Yes

No

How Fluently? (Optional)

Fair

Good

Excellent

If yes, list other fluent language(s):

List any language(s) you write in other than English:

Military Service:

MILITARY SERVICE: (A copy of a report of separation from the Armed Services may be required: DD Form 214)

Are you a veteran?

Yes

No

If yes, list type of discharge

Service Branch:

Final Rank:

Service From:

Service To:

Capability/Reliability:

CAPABILITY/RELIABILITY:

Would you be willing and able to perform all of the tasks required by the job you are applying for?

Yes

No

If no, explain which tasks:

Will you abide by the safety rules of this company?

Yes

No

Have you ever been disciplined for violating company safety rules or regulations?

Yes

No

Have you ever been fired, or asked to resign from a job?

Yes

No

If NO to question #1 or YES to questions #2 or #3, please explain:

References:

References: Provide 3 personal references - not relatives or former employers

Reference #1:

Phone:

Occupation:

Address:

CIty:

State/Province:

Zipcode:

Reference #2:

Phone:

Occupation:

Address:

City:

State/Province:

Zipcode:

Reference #3:

Phone:

Occupation:

Address:

City:

State/Province

Zipcode

Thank you for contacting us.
We will get back to you as soon as possible.

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