Employment - Wood Fundi Paving LLC.

EMPLOYMENT APPLICATION

WE ARE CURRENTLY HIRING THE FOLLOWING POSITIONS

First Name

Last Name

Street Address

City

State

Zip Code

Phone

Date of Birth

Position Desired

Date You Can Start

Desired Salary

Are You Currently Employed?

Do you have reliable transportation?

Do you have any points on your license?

Have you ever been conviced of a local, state of federal crime?

Previous Employer

Employer Phone

Dates of Employment

Position Held

Salary

Reason for Leaving

Previous Employer

Employer Phone

Dates of Employment

Position Held

Salary

Reason for Leaving

Previous Employer

Employer Phone

Dates of Employment

Position Held

Salary

Reason for Leaving

Reference Name

Address

Phone Number

Relationship to You

Reference Name

Address

Phone Number

Relationship to You

Reference Name

Address

Phone Number

Relationship to You

Authorization/Eletronic Signature

Please read below and check box to sign.

I certifiy that the facts contained in this application are true and complete to the best of my knowledge and understanding that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statement contained herein and the references and employers listed above to give you and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damages that may result from utilization of such information.

I also understand and agree that no representative of the company has any authorization to enter any agreement for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

By checking the box above, I acknowledge that I have read & understand the statements above and I agree to be bound by these statements. I also understand the checking of this box acts is my electronic signature.