Please do not leave blank
Examples: Speeding, drunk driving, etc
Please also indicate the city/state it is located
Please also indicate the city/state it is located
Please include reference's name, address, phone number, and position
Please include reference's name, address, phone number, and position
List most recent employment first. Please include past employer's name, address, your title and responsibilities, dates employed, and reason for leaving.
By including my electronic signature here, I hereby give you my permission to contact the above employers, references, and educational institutions to verify the items I listed above. I hereby release Smith Construction, Inc., and the above reference person and emloyers from all claims, liability and damages that may result from furnishing the information to you. I expressly and fully waive all written notice from prior employees.

I further specifically waive written notice and agree to the divulging of any disciplinary reports, letters of reprimand or other disciplinary action by all prior employers and hereby release my prior from all claims, liability and damage that may result from furnishing the information to you.

I authorized Smith Construction, Inc., to request a copy of my driving record information.
I further understand that any dishonest or false answer on this application or in subsequent interviews are grounds for or may result in immediate dismissal.
In consideration of my employment, I agree to conform to the rules and regulations of Smith Construction, Inc. My employment and compensation can be terminated at-will with or without cause and with or without notice at any time, at the sole discretion of Smith Construction, Inc. or myself. I agree that no one other than Smith Construction, Inc. has any authority to enter into any agreement or contract for any specified period of time, or to make any agreement contrary to the foregoing. I further agree that no one other than Smith Construction, Inc. has any authority to make any changes to this Employment Agreement unless in writing and signed by both Smith Construction, Inc. and myself.

This application will be kept for six months. You need to complete another application to be reconsidered after this date.

Smith Construction, Inc., is an equal opportunity employer. It is the policy of this organization, not to discriminate on the basis of race, sex, religion, national origin, marital status, age, weight, height, color or handicap, in the hiring, promotion, payment or discipline of employees.

We will not discriminate against a person with a covered disability under the Americans with Disabilities Act in regard to employment practices, or terms, condition and privileges of employment.

If you are a person with a handicap, you may request any needed reasonable accommodation to participate in the application process or interview process. This request should be made in advance so that we can make any accommodation.