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FHE Job Application

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EQUAL OPPORTUNITY

Foothills Excavating affords equal employment opportunity to all qualified persons without regard to race, color, religion, sex, age, national origin or veteran status.

SUBSTANCE ABUSE TESTING

The position for which you are applying requires that, if selected for employment, you must submit to a substance abuse test and receive a negative result before being employed. Each person being tested will receive a copy of the Foothills Excavating Substance Abuse Policy if and when a conditional offer of employment is extended. You may obtain further information by calling our office. Where permitted or required by law employees are also subject to random and for cause drug testing.

MAINTENANCE OF APPLICATIONS

Foothills Excavating normally keeps applications active for one (1) year from the date of application.

NOTICE TO APPLICANT: THE PROVIDING OF ANY INCOMPLETE, FALSE OR MISLEADING INFORMATION IN THIS APPLICATION, IN ANY RESUME OR SUPPORTING DOCUMENT, OR IN THE EMPLOYMENT SCREENING OR INTERVIEW PROCESS SHALL BE SUFFICIENT GROUNDS TO REFUSE TO EMPLOY OR, HAVING BEEN EMPLOYED, TO IMMEDIATELY DISCHARGE.

General Information

Desired Position

If Other, please specify

Contact Information

First Name

Middle Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Day Phone

Evening Phone (if different)

Are you 18 years of age or older?

Yes

Are you employed now?

Yes

Have you ever worked for Foothills Excavating before?

Yes

If yes, When?

Date you can start

Wage/ Salary Desired

Skill Information

If you are applying to drive or operate heavy equipment, please indicate the number of years experience you have

with ALL applicable vehicles or pieces of equipment:

Tractor Trailer

Dump Truck- Off Road

Dump Truck- On Road

Loader

Backhoe

Excavator

Grader

Compactor

Bulldozer

Scraper

Log Skidder

Crane

Please check below ALL skills that you have, tasks you have REGULARLY performed and tools/equipment you have used:

Spread gravel

Check Grades

Install Silt Fence

Install PVC Pipe

Install RCP

Dig Utility Trench

Install Storm and Sewer Structures

Read Plans and Specs

Fine Grading

Install Septic Systems

Chainsaw

Cutting Torch

Welder

Laser, Transit Level

Have you ever supervised a work crew?

Yes

Do you have a valid drivers license?

Yes

Do you have a valid commercial driver's license?

Yes

Within the last (5) Five Years, have you had any license to operate any motor vehicle suspended or revoked by any authority for any reason?

Yes

If yes, please describe, with date and reason for suspension or revocation:

Background

Have you ever:

Pled guilty or no contest to, or been convicted of a crime?

Yes

Been disciplined orally or in writing by a previous employer?

Yes

Been discharged from a place of employment?

Yes

Been asked to resign from a place of employment?

Yes

Had any professional license or certification revoked or suspended?

Yes

If you answered yes to any question above, please explain in as much detail as possible, including dates, to each question which you answered yes.

Work History

Please list information for your last four employers, beginning with the most recent. If you do not have four

prior employers, please list information for character references in remaining fields.

Employer 1

Section description goes here

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone/Mobile

Supervisor Name

Type of work/duties

Reason for leaving?

Employer 2

Section description goes here

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone/Mobile

Name of supervisor

Type of work/duties

Reason for leaving

Employer 3

Section description goes here

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone/Mobile

Name of supervisor

Type of work / duties

Reason for leaving

Employer 4

Section description goes here

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone/Mobile

Name of supervisor

Type of work/ duties

Reason for leaving

Other Information

Please list any other information that you would like the company to consider in making a decision concerning your employment such as academic or vocational training, degrees, awards, or other relevant experiences:

IMPORTANT: Please read carefully before submitting your application

I CERTIFY THAT I HAVE READ AND UNDERSTAND THE CONTENTS OF THIS APPLICATION IN ITS ENTIRETY. I

FURTHER CERTIFY THAT THE INFORMATION IN THIS APPLICATION IS TRUTHFUL AND ACCURATE BASED ON MY

PERSONAL KNOWLEDGE. I UNDERSTAND THAT ANY MISSTATEMENT OR CONCEALMENT OF FACTS WILL

SUBJECT ME TO DISQUALIFICATION BEFORE HIRING OR DISMISSAL AFTER HIRING.

I CONSENT TO FOOTHILLS EXCAVATING INC’S VERIFICATION OF ALL INFORMATION PROVIDED HEREIN OR

HEREWITH. VERIFICATION MAY INCLUDE, WITHOUT LIMITATION, OBTAINING ADDITIONAL INFORMATION AND

DOCUMENTS FROM THE APPLICANT OR THIRD PARTIES, CRIMINAL CONVICTION RECORD CHECKS AND

INTERVIEWS OF REFERENCES, PREVIOUS EMPLOYERS, SUPERVISORS AND CO-WORKERS.

I HEREBY RELEASE FOOTHILLS EXCAVATING INC FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION THAT I

MAY NOW OR HEREAFTER HAVE, INCLUDING BUT NOT LIMITED TO CLAIMS BASED ON PRIVACY,

CONFIDENTIALITY OR DEFAMATION, AS A RESULT OF ITS VERIFICATION OF ANY INFORMATION CONTAINED

HEREIN OR SUBMITTED HEREWITH OR AS A RESULT OF ITS OBTAINING ADDITIONAL INFORMATION RELATING

TO MY PROSPECTIVE EMPLOYMENT.

I FURTHER HEREBY RELEASE ANY CURRENT OR PREVIOUS EMPLOYER OR SUPERVISOR AND ANY REFERENCE

NAMED HEREIN FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION THAT I MAY NOW OR HEREAFTER HAVE,

INCLUDING BUT NOT LIMITED TO CLAIMS BASED ON PRIVACY, CONFIDENTIALITY OR DEFAMATION, AS A

RESULT OF ITS/HIS/HER HAVING PROVIDED, UPON THE REQUEST OF FOOTHILLS EXCAVATING INC TRUTHFUL,

FACTUAL INFORMATION OR ANY RECORDS OR FILES AS DESCRIBED ABOVE.

Signature

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