Employment Application Bolt Construction Employee Application Form Use the form below to inquire about employment opportunities with our company. Note that you can save your work and continue later if needed using the link at the bottom of the form. PersonalName First Middle Last Address* Street Address Address Line 2 City State 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 ZIP Code Home PhoneCell Phone*Email* Social Security #* Special Skills Certifications Employment InterestsPosition Desired* Laborer Welder Pipefitter Heavy Equipment Operator Pipe Fitter Foreman Superintendent Project Manager Estimator Draftsman Desired Pay* Date Available To Start* MM slash DD slash YYYY Have you previously worked for this company before or any of it's affiliates?* Yes No Where* When* Relatives or friends currently employed with us? Yes No Please specify who. Do you have a valid current, and full drivers license?* Yes No Selecting No to this question does not automatically disqualify you from some positions.Enter the state your drivers license is issued in.* Enter you drivers license number.* Do you have reliable means of transportation to and from work?* Yes No Do you have any dependency on drugs (prescription or not) or alcohol?* Yes No Please Explain.Have you been charged, indicted or convicted of a crime?* Yes No If yes, explain number of convictions, nature of offenses leading to convictions, how recently such offenses were committed, sentences imposed, and types of rehabilitation.Answering yes does not constitute an automatic rejection for employment. Date of the offense, seriousness, and nature of the violation, rehabilitation, and position applied for will be considered.School history:Where did you attend high school & college? (Click the + button to add a new row)*School Name & AddressMajorYears CompletedGPADegree/Diploma ReferencesList 2 people we may contact who are qualified to evaluate your capabilities. Do not include relatives.NamePositionCompanyAddressTelephoneNamePositionCompanyAddressTelephoneEmployment HistoryGive employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.Company Name (Most Recent) Address Company Address Company Address Line 2 City State 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 ZIP Code PhoneDates EmployedFromToJob Title Supervisor Base Rate of Pay (Hour/Week/Month)StartEndList jobs, duties, skills used or learned.Advancements or promotions while you worked at this company.Reason for leaving Resigned with notice Resigned without notice Terminated Please explain.Eligible for rehire? Yes No May we contact this employer for a reference? Yes No Please explain.Did you have another job before this one?* Yes No Company Name (Second Most Recent) Address Company Address Company Address Line 2 City State 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 ZIP Code PhoneDates EmployedFromToJob Title Supervisor Base Rate of Pay (Hour/Week/Month)StartEndList jobs, duties, skills used or learned.Advancements or promotions while you worked at this company.Reason for leaving Resigned with notice Resigned without notice Terminated Please explain.Eligible for rehire? Yes No May we contact this employer for a reference? Yes No Please explain.Would you like to list another previous job? Yes No Company Name (Third Most Recent) Address Company Address Company Address Line 2 City State 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 ZIP Code PhoneDates EmployedFromToJob Title Supervisor Base Rate of Pay (Hour/Week/Month)StartEndList jobs, duties, skills used or learned.Advancements or promotions while you worked at this company.Reason for leaving Resigned with notice Resigned without notice Terminated Please explain.Eligible for rehire? Yes No May we contact this employer for a reference? Yes No Please explain.Would you like to list a 4th job? Yes No Company Name (Fourth Most Recent) Address Company Address Company Address Line 2 City State 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 ZIP Code PhoneDates EmployedFromToJob Title Supervisor Base Rate of Pay (Hour/Week/Month)StartEndList jobs, duties, skills used or learned.Advancements or promotions while you worked at this company.Reason for leaving Resigned with notice Resigned without notice Terminated Please explain.Eligible for rehire? Yes No May we contact this employer for a reference? Yes No Please explain.Summarize your special skills, abilities, and qualifications.If offered a position to work for this company, how much notice do you need to offer your current employer? Military ServiceHave you ever served in the U.S. Armed Services? Yes No US Military Duties US Military Special Training US Military Rank Date entered MM slash DD slash YYYY Date discharged MM slash DD slash YYYY Have you ever been a member of the National Guard? Yes No Date entered MM slash DD slash YYYY Date discharged MM slash DD slash YYYY HEALTH/DISABILITYAre you registered disabled?* Yes No If yes, please quote your registration number and certificate expiry date. Do you have any illness/disability which causes you to take time off from work on a regular basis?* Yes No *Answering Yes does not necessarily limit your eligibility for employmentIf yes, please give detailsDid you complete this application yourself? Yes No If not, who did? Digital Signature: Entering your First Name + Middle Initial + Last Name will act as your digital signature.PhoneThis field is for validation purposes and should be left unchanged.
