Employment Application

ARNE EXCAVATING, LLC
340 Converse Road
Marion, MA 02738
office@ArneExcavating.com
508-748-2060

Please answer all questions. Résumés are not a substitute for a completed application.

We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed servicemember status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.

Position Applied For *

Full Name *

Phone Number *

Alternate Phone Number

Present Address *

How long have you lived there, in months? *

Email *

Desired Salary / Hourly Rate

If under the age of 18, can you produce the necessary work certificate at the time of employment? *

yes

no

Type of employment desired? *

Full-time

Part-time

Specify Hours *

Are you willing to work overtime? *

yes

no

Date on which you can start work if hired *

Have you previously applied for employment at this Company? *

yes

no

If yes, when and where did you apply? *

Have you ever been employed by this Company? *

yes

no

If yes, provide dates of employment, location and reason for separation from employment.

If applicable, below list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc. *

Education
Enter school name, school address, and course of study or major. Did you graduate? # of years completed and honors received.

High School Details

College Details

Graduate or Professional Details

Trade or Correspondence Details

Work Experience
Please list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer "see résumé".

Employer 1

Employer Name

Address

Telephone

Dates Employed

Job Title

Duties

Supervisor's Name

May we contact?

yes

no

If No, why not?

Starting & Final Wages

Reason for leaving?

What will this employer say was the reason your employment terminated?

Were you ever disciplined? If so, for what?

How much notice did you give when resigning? If none, explain.

Employer 2

Employer Name

Address

Telephone

Dates Employed

Job Title

Duties

Supervisor's Name

May we contact?

yes

no

If No, why not?

Starting & Final Wages

Reason for leaving?

What will this employer say was the reason your employment terminated?

Were you ever disciplined? If so, for what?

How much notice did you give when resigning? If none, explain.

3. Employer name, address, type of business, as well as all data required above.

4. Employer name, address, type of business, as well as all data required above.

Have you ever been terminated or asked to resign from any job? *

yes

no

If yes, how many times?

Has your employment ever been terminated by mutual agreement? *

yes

no

If yes, how many times?

Have you ever been given the choice to resign rather than be terminated? *

yes

no

If yes, how many times?

If you answered yes to any of the above three questions, please explain the circumstances of each occasion.

References

Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related references.

1. List name, position, company, work relationship (i.e. supervisor, co-worker), and telephone. *

2. List name, position, company, work relationship (i.e. supervisor, co-worker), and telephone. *

Please list the names of personal references (not previous employers or relatives) who you know that we may contact.

1. List name, occupation, address, telephone, number of years known. *

2. List name, occupation, address, telephone, number of years known. *

Driving Information [Optional] Complete only if driving is an essential function of the job for which you are applying.

Do you have a current valid driver's license? *

yes

no

If yes, license number, state, and expiration date

If you do not have a driver's license for the state in which you currently reside, why not?

Has your license ever been suspended or revoked? *

yes

no

If yes, explain why your license has been suspended or revoked.

Do you have personal automobile insurance? *

yes

no

If no, explain why you do not have automobile insurance.

Have you ever been denied personal automobile insurance or has it ever been terminated or suspended? *

yes

no

If yes, explain why terminated or suspended.

Please list all moving violations in the last five (5) years. Include offense, date, location, and comments.

APPLICATION CERTIFICATION

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver's license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state were I reside.

I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent which applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.

I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement.

I certify that all the information on this application, my résumé, or any supporting documents I may present during my interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OR THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT - EXPRESS OR IMPLIED - WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY. IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY HAS COMPLETED DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.

I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state, or local law. If applicable and allowed by law, I will receive separate written notification regarding the Company's intent to obtain "consumer reports."

I authorize and consent to, without reservation, any party of agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representatives pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representatives for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the Company harmless for providing such information.

If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States.

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE.

DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION.

Sign this document by typing in your full name. *

Signature: By checking this box you are accepting the terms of this agreement listed in the APPLICANT CERTIFICATION. *

I AGREE

IT IS UNLAWFUL IN MASSACHUSETTS TO REQUIRE OR ADMINISTER A LIE DETECTOR TEST AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. AN EMPLOYER WHO VIOLATES THIS LAW SHALL BE SUBJECT TO CRIMINAL PENALTIES AND CIVIL LIABILITIES. FEDERAL AND/OR STATE LAW MAY PROHIBIT THE USE OF LIE DETECTOR, POLYGRAPH OR SIMILAR TEST AS WELL.