O’BRIEN CONSTRUCTION & GENERAL CONTRACTING, INC. APPLICATION FOR EMPLOYMENT Please complete this form below and hit SUBMIT at the end of the form to send your application. If you have trouble completing this form online, simply print it, fill it out, and FAX to 888-622-4151 -or- email a copy to [email protected]. Call Dianne at 508-954-4357 with any questions. Thank you. CANDIDATE INFORMATION Last Name ____________________________________________ First Name ____________________________________________ Middle Initial ____________________________________________ Street Address ____________________________________________ City ________________State_____Zip________________ Home phone ____________________________________________ Cell phone ____________________________________________ Education: High School – Name __________ Graduate: Yes____No____ Year _______ Trade School – Name __________ Graduate: Yes____No____ Year _______ Subject _____________ College – Name __________ Graduate: Yes____No ____ Year _______ Subject ____________ Most Recent Employer ____________________________________________ Most Recent Position _____________________________________________ How did you hear about O’Brien Construction? _______________________________________ ___________________________________________________________________________ SALARY DESIRED (REQUIRED) _____________________________ EMPLOYMENT HISTORY: Company Name _______________________________ Dates From ________________ To________________ Position _____________________________________ Duties/Responsibilities _________________________ ____________________________________________ Salary __________________ Company Name _______________________________ Dates From ________________ To________________ Position _____________________________________ Duties/Responsibilities _________________________ ____________________________________________ Salary __________________ Company Name _______________________________ Dates From ________________ To________________ Position _____________________________________ Duties/Responsibilities _________________________ ____________________________________________ Salary __________________ REFERENCES List supervisors, coworkers, or others familiar with your work experience, but not related to you, Prefer that at least one reference was a supervisor. Name ____________________________________________ Company/School ____________________________________________ Position ____________________________________________ Phone and/or email ____________________________________________ Name ____________________________________________ Company/School ____________________________________________ Position ____________________________________________ Phone and/or email ____________________________________________ Name ____________________________________________ Company/School ____________________________________________ Position ____________________________________________ Phone and/or email ____________________________________________ ADDITIONAL INFORMATION Use this space to summarize your relevant work experience, any unique skills you possess, and any other relevant information you would like us to know. _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ AGREEMENT/SIGNATURE By typing my name here, I am certifying that the data provided is correct to the best of my knowledge and belief. I understand that any misrepresentation in this application may result in refusal or separation from employment. I authorize investigation of all statements contained herein and authorize the references listed to give O’Brien Construction & General Contracting any and all information concerning my previous employment and any pertinent information they may have, and Release all parties from all liability for any damage that may result from furnishing information for this employment application. By typing my name here, I am electronically “signing” this agreement, which certifies that I have read and agree with the above statements. Signature__________________________________________________________________ Date ____________________________________________________________________ Questions should be directed to Dianne Fayle at [email protected] SUBMIT
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