o`brien construction & general contracting, inc. application for

O’BRIEN CONSTRUCTION & GENERAL CONTRACTING, INC.
APPLICATION FOR EMPLOYMENT
Please complete this form below and hit SUBMIT at the end of the form to send your application.
If you have trouble completing this form online, simply print it, fill it out, and
FAX to 888-622-4151 -or- email a copy to [email protected].
Call Dianne at 508-954-4357 with any questions. Thank you.
CANDIDATE INFORMATION
Last Name
____________________________________________
First Name
____________________________________________
Middle Initial
____________________________________________
Street Address ____________________________________________
City
________________State_____Zip________________
Home phone
____________________________________________
Cell phone
____________________________________________
Education:
High School – Name __________ Graduate: Yes____No____ Year _______
Trade School – Name __________ Graduate: Yes____No____ Year _______ Subject _____________
College – Name __________ Graduate: Yes____No ____ Year _______ Subject ____________
Most Recent Employer ____________________________________________
Most Recent Position _____________________________________________
How did you hear about O’Brien Construction? _______________________________________
___________________________________________________________________________
SALARY DESIRED (REQUIRED) _____________________________
EMPLOYMENT HISTORY:
Company Name _______________________________
Dates From ________________ To________________
Position _____________________________________
Duties/Responsibilities _________________________
____________________________________________
Salary __________________
Company Name _______________________________
Dates From ________________ To________________
Position _____________________________________
Duties/Responsibilities _________________________
____________________________________________
Salary __________________
Company Name _______________________________
Dates From ________________ To________________
Position _____________________________________
Duties/Responsibilities _________________________
____________________________________________
Salary __________________
REFERENCES
List supervisors, coworkers, or others familiar with your work experience, but not related to you, Prefer that
at least one reference was a supervisor.
Name
____________________________________________
Company/School
____________________________________________
Position
____________________________________________
Phone and/or email
____________________________________________
Name
____________________________________________
Company/School
____________________________________________
Position
____________________________________________
Phone and/or email
____________________________________________
Name
____________________________________________
Company/School
____________________________________________
Position
____________________________________________
Phone and/or email
____________________________________________
ADDITIONAL INFORMATION
Use this space to summarize your relevant work experience, any unique skills you possess, and any other
relevant information you would like us to know.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
AGREEMENT/SIGNATURE
By typing my name here, I am certifying that the data provided is correct to the best of my knowledge and
belief. I understand that any misrepresentation in this application may result in refusal or separation from
employment. I authorize investigation of all statements contained herein and authorize the references listed to
give O’Brien Construction & General Contracting any and all information concerning my previous employment
and any pertinent information they may have, and
Release all parties from all liability for any damage that may result from furnishing information for this
employment application.
By typing my name here, I am electronically “signing” this agreement, which certifies that I have read and agree
with the above statements.
Signature__________________________________________________________________
Date
____________________________________________________________________
Questions should be directed to Dianne Fayle at [email protected]
SUBMIT