Employment Application

Application for Employment

Summit/Catamount Construction, LLC
13 Shed Road
Berlin, VT 05602

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A new window will open. Browse to and select your resume on your local machine, click the 'Attach' button,
and close the window when indicated. Your resume will be attached to your Application for Employment.

Personal Information

Full Name:
Address:

Email:
Telephone:	Mobile/Other Phone:
If necessary, best time to call you at home is
May we contact you at work? If yes, work number

Social Security #:

Position(s) applied for:
Date of Application:
Referral Source:
If you are under 18 and it is required can you furnish a work permit?
If no, please explain
Have you submitted an application here before?
If yes, give date(s) and positions(s):
Date: Position:
Date: Position:
Have you been employed here before?
If yes, give dates From: To:
Are you legally eligible for employment in this country?
Date available for work
What is your desired salary range or hourly rate of pay?
$ Per
Type of employment desired
Will you relocate if job requires it?
Will you travel if job requires it?
Will you work overtime if required?
If no please explain
Driver's license number required if driving may be required in the job for which you are applying: Driver's License Number: State
Have you ever been bonded?
Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.
Have you ever pled "guilty" or "no contest" to or been convicted of a crime?
If yes, please provide date(s) and details:

Employment History
Starting with your most recent employer, provide the following information

Employer	Telephone #
Street address	City	State
Dates employed: to

Employer	Telephone #
Street address	City	State
Dates employed: to

Employer	Telephone #
Street address	City	State
Dates employed: to

Employer	Telephone #
Street address	City	State
Dates employed: to

Explain any gaps in your employment, other than those due to personal illness, injury or disability

If not addressed on previous section, have you ever been fired or asked to resign from a job?
If yes, please explain

Skills and Qualifications
Summarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying.

Computer Skills:

Software Type	Software Titles	Years Used

Educational Background
Starting with your most recent school attended, provide the following information

School (include City & State)
Highest Degree Obtained:
Years Completed:		GPA
Describe any Degrees:
Major:		Minor

School (include City & State)
Highest Degree Obtained:
Years Completed:		GPA
Describe any Degrees:
Major:		Minor

School (include City & State)
Highest Degree Obtained:
Years Completed:		GPA
Describe any Degrees:
Major:		Minor

References
List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

Name	Title	Relationship to You	Telephone	Number of Years Known

Related Information
To what job-related organizations (professional, trade, etc.) do you belong?
               Exclude memberships that would reveal race, color, religion, sex, national origin,
                    citizenship, age, mental or physical disabilities, veteran/reserve national guard or
                    any other similarly protected status.

In your current or a prior job, have you ever written instruction or directions to be followed by employees or customers?
If yes, please explain:

Is there any other job-related information you want us to know about you?

By clicking Submit below I certify that all information I have provided is true, complete and correct.

Summit/Catamount Construction, LLC, 13 Shed Road, Berlin, VT 05602
Phone: (802) 223-6764 ~ Fax: (802) 229-4603 ~ Email: Staff
Copyright © 2006 Summit/Catamount Construction, LLC. Site Designed and Maintained by Michael Barnes