Careers

Employment Application

You call fill out the below application below or print a PDF formated application by downloading it from the link to the right and then mail it to: P.O. Box 37, 164 S. 1st Street - Blair, NE 68008

First Name

Middle

Last

Day Phone

Other Phone

Current Address

Street

City

State

Zip

Applying for:

How many hours can you work per week?

Date Available

Rate of Pay Expected

General Information

Have you worked for this company before?

Yes

From:

To:

Where:

Rate of Pay:

Position:

Reason for leaving:

Names of relatives employed by this company:

Are you currently employed?

Yes

If you are currently employed, may we contact
your present employer?

Yes

Are you at least 18 years old?
(If under 18, hire is subject to verification
that you are of minimum legal age.)

Yes

If hired, can you present evidence of your U.S. citizenship or
proof of your legal right to live and work in this country?

Yes

Have you ever been convicted of a criminal offense
felony or serious misdemeanor?

Yes

If YES, please explain fully on a in the space below.

Conviction of a crime is not an automatic bar from employment.
All circumstances will be considered.

Have you ever worked for this company under another name?

Yes

If so, what name?

Physical demands of roofing work such as lifting repeatedly over 100lb., twisting, and bending are part of the job. Do you have any physical limitations that would restrict your ability to perform this kind of work?

Yes

If yes, describe the functions that cannot be performed.

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

If the job requires, do you have a valid driver’s license?

Yes

Licence #

Type:

State Issue:

Education

Select the highest grade completed:

Grade School:

College:

Do you speak, write or understand any foreign languages?

Yes

If yes, which languages?

Employment History

List below all present and past employment, starting with your most recent employer. Account for periods of unemployment.

Employer

Street

City

State

Zip

Telephone

Wage

Position & Duties

From

Reason for Leaving

Employer

Street

City

State

Zip

Telephone

Wage

Position & Duties

From

Reason for Leaving

Employer

Street

City

State

Zip

Telephone

Wage

Position & Duties

From

Reason for Leaving

Construction Experience and Qualifications

List specific training in construction work or roof mechanics

Automotive Shop:

Sheet Metal and Shop Equipment:

Roof Mechanics and Construction Equipment:

List types of platform experience and number of years of each

List platform equipment you can operate:
(Forktruck, Lull, Scissor Lift, etc.)

List formal Training that qualifies you as a Forktruck operator:

List formal training and experience with scaffolding:

I hereby certify that I have not knowingly withheld any information that might adversely affect my changes for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application of on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Under the Fair Credit Reporting Act, Public Law 91-508, I agree, understand and I hereby authorize the company to thoroughly investigate my references, work record, education, driving record, and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect that use of illegal drugs prior to employment and/or during employment.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company, is for no definite or determinable period and may be terminated at any time (at will), with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s designated representative.

I understand that I am being hired as an at will employee.