Application

Contact Information

Please answer the following questions. If not applicable, please list N/A.

Be sure and PRINT this application for your records, PRIOR to submitting. Follow up with us to confirm receipt of your application. Thank you!

DATE AVAILABLE TO START:

DATE AVAILABLE TO START:

ARE YOU AVAILABLE TO WORK (SELECT ALL THAT APPLY)

ARE YOU AVAILABLE TO WORK (SELECT ALL THAT APPLY)

FULL TIME SEASONAL

SUMMER ONLY

OVERTIME (INCLUDING WEEKENDS)

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HAVE YOU EVER WORKED FOR BRYSON GRADING BEFORE?

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HAVE YOU EVER APPLIED TO BRYSON GRADING BEFORE?

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POSITION DESIRED

WORK EXPERIENCE

ARE YOU CURRENTLY EMPLOYED?

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PROVIDE YOUR WORK HISTORY FOR (AT MINIMUM) THE LAST 3 YEARS TO PRESENT.

JOB TITLE

COMPANY

NAME

START DATE:

END DATE:

IMMEDIATE

SUPERVISOR

SUPERVISOR

PHONE #

MAY WE CONTACT PREVIOUS EMPLOYER

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PAY RATE

JOB DESCRIPTION

SPECIAL SKILLS, EQUIPMENT, AND CERTIFICATIONS:

REASON FOR LEAVING

JOB TITLE

START DATE:

END DATE:

IMMEDIATE

SUPERVISOR

SUPERVISOR

PHONE #

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MAY WE CONTACT PREVIOUS EMPLOYER

PAY RATE

JOB DESCRIPTION

SPECIAL SKILLS, EQUIPMENT, AND CERTIFICATIONS:

REASON FOR LEAVING

JOB TITLE

COMPANY

NAME

START DATE:

END DATE:

IMMEDIATE

SUPERVISOR

SUPERVISOR

PHONE #

MAY WE CONTACT PREVIOUS EMPLOYER

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PAY RATE

JOB DESCRIPTION

SPECIAL SKILLS, EQUIPMENT, AND CERTIFICATIONS:

REASON FOR LEAVING

DRIVING INFORMATION

DRIVERS LICENSE NUMBER

DO YOU HAVE A COMMERCIAL DL?

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EXPIRATION DATE

ENDORSEMENTS

IF YES, HOW LONG HAVE YOU HAD YOUR CDL?

DRIVERS LICENCE CLASS (CDL ONLY)

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STATE OF ISSUE

TYPE OF TRUCK/EQUIP OPERATE/REPAIR. LIST YEARS OF EXP. FOR EACH.

EDUCATION

HIGH SCHOOL

NAME & LOCATION

YEARS ATTENDED

DID YOU GRADUATE?

DEGREE

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COLLEGE

DEGREE

DID YOU GRADUATE?

YEARS ATTENDED

NAME & LOCATION

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TRADE, BUSINESS, OR CORRESPONDENCE SCHOOL

DEGREE

DID YOU GRADUATE?

YEARS ATTENDED

NAME & LOCATION

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REFERENCES

Please list two persons not related to you that we may call/email for reference.

NAME

EMAIL

PHONE

JOB TITLE

RELATIONSHIP TO YOU

PHONE

EMAIL

NAME

JOB TITLE

RELATIONSHIP TO YOU

ACCIDENT RECORD

Please list your accident record for the past 5 years. if not applicable, select "NO" from the dropdown.

HAVE YOU HAD ANY ACCIDENTS IN THE LAST 5 YEARS?

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If "YES", answer all of the following in the box below:

1. Date of Accident

2. Type of accident (example: rear end, head on collision) 

3. Were there fatalities

4. Were there injuries

Include ALL accidents in the last 5 years. 

TRAFFIC RECORD

Please list your moving violations in the past 5 years. if not applicable, select "NO" from the dropdown.

HAVE YOU HAD ANY ACCIDENTS IN THE LAST 5 YEARS?

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Please list your moving violations the past 5 years. if not applicable, select "NO" from the dropdown.

AUTHORIZATION

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

I authorize investigation of all statements contained herein and the references and employers listed above to give you any 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 damage that may result from utilization of such information.

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

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment"

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

AUTHORIZATION STATEMENT ACKNOWLEDGEMENT
ELECTRONIC SIGNATURE (TYPE FULL NAME HERE)
DATE

Be sure and PRINT (CTR+P on your keyboard) this application for your records, PRIOR to submitting. Follow up with us to confirm receipt of your application. Thank you!

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