Employment Application

Step 1 of 8

12%

• Personal Information

• Name*
  First Last
• Address*
  Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Phone*
• Email*

• Job Interest

• Position Desired*
• Date You Can Start*
  MM slash DD slash YYYY
• List Equipment Experience & Type of Work Your Skills Were Used*
• Pay Desired (per Hour)*
• Are You Able To Work Full Time?*
  • Yes
  • No
• How were you referred to us?
• Will you be willing to work overtime and/or Saturdays?*
  • Yes
  • No
• Have you ever applied for work at John Eramo & Sons Inc. before?*
  • Yes
  • No
• Have you ever been employed with John Eramo & Sons Inc. before?*
  • Yes
  • No
• If yes, when?
• Who was your supervisor?
• Do you know anyone who works here?
  • Yes
  • No
• Who?

• Education and Training

• Select The Highest Grade Completed In Grade/High School*
  12th Grade11th Grade10th Grade9th Grade8th Grade7th Grade6th Grade5th Grade4th Grade3rd Grade2nd Grade1st Grade
• Select The Highest Years Completed of College*
  One (1) YearTwo (2) YearsThree (3) YearsFour (4) YearsFive (5) Years
• Select The Highest Years Completed of Trade/Tech*
  One (1) YearTwo (2) YearsThree (3) YearsFour (4) Years
• What extracurricular activities did you participate in, or special skills did you acquire, which might be helpful for the job in which you are applying?*

• Work Experience

• Are you presently employed?*
  • Yes
  • No
• Have you filed for unemployment benefits?*
  • Yes
  • No
• Are you on layoff subject to recall?*
  • Yes
  • No
• If yes, where?
• Present or Last Employer
• Address
• Kind of Business
• Phone
• Starting Position
• Starting Pay
• Final Position
• Final Pay
• Starting Date
  MM slash DD slash YYYY
• Final Date
  MM slash DD slash YYYY
• Name of Supervisor
• Reason For Leaving
• Description of Work and Responsibilities
• Will you receive a satisfactory reference from this employer?
  • Yes
  • No
• If "No" please explain
• May we contact them at this time?
  • Yes
  • No
• If "No" please explain
• Other Present or Last Employer
• Address
• Kind of Business
• Phone
• Starting Position
• Starting Pay
• Final Position
• Final Pay
• Starting Date
  MM slash DD slash YYYY
• Final Date
  MM slash DD slash YYYY
• Name of Supervisor
• Reason For Leaving
• Description of Work and Responsibilities
• Will you receive a satisfactory reference from this employer?
  • Yes
  • No
• If "No" please explain
• May we contact them at this time?
  • Yes
  • No
• If "No" please explain
• Other Present or Last Employer
• Address
• Kind of Business
• Phone
• Starting Position
• Starting Pay
• Final Position
• Final Pay
• Starting Date
  MM slash DD slash YYYY
• Final Date
  MM slash DD slash YYYY
• Name of Supervisor
• Reason For Leaving
• Description of Work and Responsibilities
• Will you receive a satisfactory reference from this employer?
  • Yes
  • No
• If "No" please explain
• May we contact them at this time?
  • Yes
  • No
• If "No" please explain

• Official Information

• Do you have, or have you applied for the right to remain permanently and work in the United States?*
  • Yes
  • No
• Have you ever been discharged or asked to resign by an employer?*
  • Yes
  • No
• If "Yes" please explain
• 
  A record of criminal conviction may not automatically be a bar to employment, since the Company will consider facts such as age, time of the offense, the nature and seriousness of the violation, and the evidence of rehabilitation in making any employment decision.
  
• Have you ever been convicted of a crime, other than minor traffic violations?*
  • Yes
  • No
• If "Yes" please explain
• Do you have a valid driver's license?*
  • Yes
  • No
• Driver's License Number
• State
  AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
• Are you Drug Free?*
  • Yes
  • No
• Are you willing to be drug trested?*
  • Yes
  • No
• Are you currently a Tobacco user?*
  • Yes
  • No
• If Yes, are you willing to participate in and complete a tobacco cessation program as a condition of employment?
  • Yes
  • No

• John Eramo & Sons is a tobacco free workplace as of October 1, 2009.

• Military Experience

  Completing this section is optional. Leave blank if you do not wish to answer.

• Have you ever been in the United States Armed Services?
  • Yes
  • No
• Which Branch?
• Dates of Service
• Describe any skills you acquired in the Service which would be useful to the job in which you are applying:

• References

  Completing this section is optional. Leave blank if you do not wish to answer.

  List the name of any professional or personal character reference who has known you for the last three years and from whom you can obtain letters of recommendation. Please do not list relatives.

• Name
• Occupation
• Phone
• Relationship to Applicant
• Address
  Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State
• Name
• Occupation
• Phone
• Relationship to Applicant
• Address
  Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State
• Name
• Occupation
• Phone
• Relationship to Applicant
• Address
  Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State

• Please Read The Following Carefully

  By singing below, I certify that I have read, understand and agree to each of the following statements.

  All of the information I have supplied on this application is correct, accurate and complete to the best of my knowledge. I have not knowingly withheld any information that, if known to the Company, would affect my application unfavorably.

  If I am employed by the Company, and the Company determines at any time during my employment that any of the statements on this application are false, misleading, or incomplete, I may be terminated immediately.

  This application will be active for 120 days from the date below. If I want to be considered for a job with the Company after this period, I must fill out another application.

  If offered a position, I agree to submit to pre-employment drug and alcohol testing prior to beginning work with the Company, and understand that a positive test will result in the cancellation of any job offer. I understand that if I am employed by the Company, I may be required, when job related and consistent with Company Policy, to undergo a medical examination or testing for drugs and alcohol. I further understand that I may be required to submit to a drug and alcohol test at any time. In consideration of my employment with the Company, I agree to abide by all Company policies.

  I understand that nothing in this employment application creates a contract of employment between me and the Company. If I am hired by the Company, my employment and compensation are "at will," which means that my employment can be terminated, either by the company or me, with or without notice. I understand that no supervisor has the authority to make any employment agreement with me, either in writing or orally, which is not an "at will" agreement.

  I give the Company my permission to conduct any investigation regarding the information contained in this application. I give the Company permission to contact any former employer, personal or professional reference, or any other appropriate source for the purpose of gathering information about any qualifications, personal or otherwise. I give my consent to any listed source to release to the Company any information they have about me. I also unconditionally release all named and unnamed sources from any and all liability that might result from furnishing any information about me.

• Date
  MM slash DD slash YYYY
• Signature
• CAPTCHA
• Name
  This field is for validation purposes and should be left unchanged.