Superior Ready Mix Concrete, L.P.

Employment Application

An Equal Opportunity Employer

Personal

First name:

Last name:

Middle Initial:

Address:

City: State: Zip Code:

Email Address:

Home Phone No.

Celluar Phone No.

Other Phone No.

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?

YES NO

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?

YES NO

General Information

Position Desired : Desired Salary :$ Date Available:

If other position please specify:  

To which region are you applying?:

How did you hear about us? (Referral):

If referred by employee, newspaper, or other, please specify:

Work History

May we contact your present employer? YES NO

*Fill in as many past employers as possible

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

Company

Address

Supervisor

Phone

Position:

Duties:

Dates:

From: To:

Salary:

Start: Finish:

Reason For Leaving:

 

Have you ever been convicted of a criminal offense (felony or serious misdomeanor)? YES NO

If yes, state the nature of the crime(s), when and where convicted and disposition of case:

*No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position applied for may, however, be considered.
 
Military Service
 

Have you obtained any special skills or abilities as a result of service in the military? YES NO

If So, Describe:

 
For Driving Applicants Only
 

Check equipment you have experience driving and provide years of experience. Check drivers license endorsements and class of license you currently hold. (check all that apply)

Mixer    Bottom Dump    Transfer Truck    Pneumatic

Tank    Double/Triples    Hazardous Materials           Class A Class B

Does your license have any restrictions that prohibit you from driving a manual transmission? YES NO
 
Education
 
Type of School Name of School & Location Major Course Studied Choose Highest Year Completed Degree/Diploma
High School


College

Business
Other
 

Additional Remarks:

 

 

PLEASE READ CAREFULLY

Superior Ready Mix Concrete, L.P. is an Equal Opportunity Employer and does not discriminate in hiring on the the basis of race, color, national origin, sex, age, disability, verteran status, or any other basis prohibited by federal, state or local ordinance. The information contained in this employment application will be used solely to determine your qualifications for the position for which you applied.

I authorize investigation of all statements contained in this application. I understand that falsification, misrepresentation or omission of facts called will result in immediate dismissal or removal of my application from consideration. I authorize Superior Ready Mix to secure information about my experience with former employers, educational institutions and agencies, and for those parties to provide information concerning my experience, releasing all parties from liability.

I agree that should I be offered employment by Superior Ready Mix, I will submit to a post-offering urinalysis test for the purpose of detecting illegal drugs and/or alcohol. My failure to cooperate will result in being removed from consideration for employment. I also understand that any offers for employment will be withdrawn if illegal drugs and/or alcohol are detected through testing.

Superior Ready Mix is an at-will employer, which means the employee, or Superior Ready Mix may terminate my employment for any reason at any time, with or without cause.

I CERTIFY THAT I HAVE READ AND UNDERSTOOD THE FOREGOING AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE INFORMATION ON THIS FORM IS TRUE AND CORRECT.

SIGNED x                      DATE: 

 
 

Attach Resume or other document:   

 
 

AFFIRMATIVE ACTION SURVEY

The Federal Government under Executive Order 11246 requires the corporation to report gender and race/ethnic origin of applicants for employment.  As an employer/government contractor, we comply with government regulations and affirmative action responsibilities.  Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap.  Submission of information is voluntary, and failure to provide it will not subject you to any adverse treatment.  This data is for periodic government reporting and will be kept in a confidential file separate from the Application for Employment.

Your cooperation is appreciated!

 
PERSONAL INFORMATION

Last Name: First Name: M.I
Position Applied For:
GENDER AND ETHNIC GROUP

Check One: Male Female I prefer not to answer this question

Check One: Hispanic or Latino Not Hispanic or Latino I prefer not to answer this question

* Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.  This does not include persons of Portuguese decent or persons from Central or South America who are not of Spanish origin or culture.

 
RACE

I prefer not to answer this question.

White (Not Hispanic or Latino) – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino) – A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) – A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino) – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

American Indian or Alaska Native (Not Hispanic or Latino) – A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino) – All persons who identify with more than one of the above five races.