List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here. If you run out of spots to fill, add extra jobs to the summary at the end of this section. No more than 10 years history recommended.

Summarize Other EMployment Related to this Job:

List two personal references who are not relatives or former supervisors that are listed above under employment history.

If you have any additional business references that you wish to list that are not named above, please list them here.

Due to the nature of work performed by Myers Construction, Inc. please answer the following questions about your physical ability to perform the necessary functions on the job. Honestly answering the below questions will not disqualify you from consideration. However, if hired, you may be placed in an area of work that best utilizes your abilities until further review of your performance.

For the past three years or more.

For the past three years.

If you are a CDL holder, please list whom we may contact to ask about your previous driving record

I hereby certify that the information and statements contained in this application are correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I hereby authorize any of the persons or organizations listed in my application to give all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and release all such parties from all liability that may result from furnishing such information to you. I authorize you to request and receive such information.

In consideration for my employment and my being considered for employment by your company, I agree to adhere to the rules and regulations of the company and hereby acknowledge that these rules and regulations may be changed by your company at any time, at the company’s sole option and without any prior notice.

In addition, I acknowledge that my employment may be terminated, and any offer of employment, if such is made, may be withdrawn, with or without prior notice, at any time, at the option of either the company or myself. I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to assure or make some other personnel move, either prior to commencement of employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or to make any agreement, that is contrary to the foregoing.

I hereby acknowledge that I have been advised that this application will remain active for no more than 90 days from the date it was signed and I may have to submit an updated application after that time. I also hereby acknowledge that Myers Construction, Inc. verifies all new employment through the E-Verify system and that two forms of government-issued identification are required before employment is allowed to start.