Employment Application

Referred by

Date available to start

1. Position Applied For

Position(s) applying for (check all that apply) *

CDL Driver — Class A CDL Driver — Class B Equipment Operator Laborer Mechanic / Diesel Tech

Employment type desired

Hourly wage expected ($/hr)

Willing to work

Overtime Weekends Nights On-call

Willing to travel / work at remote job sites or camp?

Yes No

Have you ever applied here before?

Yes No

If yes, when:

How did you hear about this position?

2. Contact Information

Last name *

First name *

Middle

Preferred name

Physical Address

Physical street address

City

State

ZIP

How long at address

Mailing Address

My mailing address is different from my physical address

Primary phone *

Secondary phone

Email *

Best way to reach you

Call Text Email

Best time to contact

3. Work Eligibility

If hired, you will be required to provide documentation establishing identity and employment authorization as required by federal law.

Are you legally authorized to work in the United States?

Yes No

Are you at least 18 years of age?

Yes No

Have you ever worked for this company (or any related entity) before?

Yes No

If yes, when and where: Do you have any relatives currently employed here?

Yes No

If yes, name / relationship:

4. Driving & CDL Qualifications

Complete this section if you are applying for any driving position. Do not include your driver's license number here — it will be collected separately if you are hired. If hired, we will also need a copy of your driving record (MVR).

Valid driver's license?

Yes No

5. Heavy Equipment Experience

For each piece of equipment you can operate, check the box and indicate years of experience and skill level. (B = Beginner, I = Intermediate, E = Expert)

Equipment	Operated?	Years	Level	Make / model (optional)
Wheel loader (small/mid)
Wheel loader (large — 950 and up)
Track loader (crawler loader)
Dozer (D6 and under)
Dozer (D7 and up)
Hydraulic excavator (small — under 20T)
Hydraulic excavator (mid — 20–40T)
Hydraulic excavator (large — 40T+)
Motor grader
Articulated haul truck (off-road)
Rigid frame haul truck
Scraper / pan
Skid steer / compact track loader
Backhoe / loader-backhoe
Compactor / roller (smooth drum)
Compactor (padfoot / sheepsfoot)
Crusher (jaw / cone / impact)
Screen plant / wash plant
Conveyor / stacker
Rock truck / belly dump loader duty
Forklift / telehandler
Boom lift / scissor lift
Rubber-tire hoe
Tracked excavator attachments (hammer/shear/grapple)

Total years of heavy equipment experience

Other equipment / skills not listed above

6. Certifications, Training & Safety

Check all current certifications. You may bring copies of cards or certificates to an interview when applicable.

Certifications (check all held)

Other certification #1

Other certification #2

Are you able to perform the essential functions of the position you are applying for, with or without reasonable accommodation?

Yes No

Willing to submit to pre-employment and random drug/alcohol testing per DOT and company policy?

Yes No

7. Work History

List your three (3) most recent employers, most recent first. Include periods of unemployment. If your three most recent jobs do not cover at least the past year, include additional earlier employers in the “additional employers” box at the end of this section.

Employer #1

Company name

Phone

Address (city, state)

Job title

Supervisor

Start (mo/yr)

End (mo/yr)

Starting pay

Ending pay

May we contact this employer?

Duties / equipment operated / type of work Reason for leaving

Employer #2

Company name

Phone

Address (city, state)

Job title

Supervisor

Start (mo/yr)

End (mo/yr)

Starting pay

Ending pay

May we contact this employer?

Duties / equipment operated / type of work Reason for leaving

Employer #3

Company name

Phone

Address (city, state)

Job title

Supervisor

Start (mo/yr)

End (mo/yr)

Starting pay

Ending pay

May we contact this employer?

Duties / equipment operated / type of work Reason for leaving Additional employers (only if your three most recent don't cover at least a year) Any gaps in employment over one month in the past 10 years?

Yes No

If yes, explain

8. Education & Training

Level	School / program name & location	Years / dates	Completed?	Degree / diploma / cert
High school / GED
Trade school / technical
College (2-year)
College (4-year)
Other training

9. Military Service (Optional)

Have you served in the U.S. Armed Forces?

Yes No

Branch

Rank at discharge

Dates of service

MOS / specialty

Relevant skills, equipment, or training from military service

10. Professional References

List three (3) professional references (former supervisors, coworkers, or others familiar with your work — not family members).

#1 Name

Relationship / how you know them

Phone

Years known

#2 Name

Relationship / how you know them

Phone

Years known

#3 Name

Relationship / how you know them

Phone

Years known

11. Additional Information

Tell us anything else you'd like us to know — skills, interests, why you want this job, or anything that makes you a good fit.

Resume (Optional)

Attach your resume

PDF, Word (.doc / .docx), RTF, or plain text. 5 MB maximum.

12. Applicant Certification & Signature

Please read the following statements carefully before signing.

I certify that all information I have provided on this application is true, complete, and accurate to the best of my knowledge. I understand that any false statement, omission, or misrepresentation is grounds for refusal to hire or, if discovered after hire, for immediate termination of employment at any time.
I authorize the Company to contact my previous employers, schools, references, and other individuals and organizations to verify the information I have provided and to gather any additional information about my qualifications, work history, and suitability for employment, except as I have specifically noted otherwise in this application. I release all such parties from any liability arising from providing this information.
I understand that if I am hired, my employment is “at will,” meaning that either I or the Company may terminate the employment relationship at any time, with or without cause or notice, and that no promise of continued employment has been made to me and no such promise is implied by this application or any subsequent hiring decision.
I understand that nothing contained in this application or in any interview is intended to create an employment contract.
I understand that, if hired, I will be required to provide documentation establishing my identity and authorization to work in the United States in accordance with federal law, and that I may be required to pass a pre-employment drug and alcohol screening, a physical capability assessment, and/or a motor vehicle record check appropriate to the position.
I understand that I will be asked to provide sensitive information (such as Social Security number, driver's license number, and similar identifying information) only after a conditional offer of employment is made, for purposes of tax reporting, I-9 verification, DOT qualification, payroll, and similar lawful purposes.

I certify that the statements above are true and I agree to the conditions listed. * Type your full name as your electronic signature *

Submission date is recorded automatically by the server.

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