Heavy Equipment Application - Blackheart Building

Please fill out the application below. Thank you for your interest.

Personal information

Name(Required)

First Middle Last

Date of Birth(Required)

MM slash DD slash YYYY

Address(Required)

Street Address Address Line 2 City State ZIP Code

Home Phone(Required)

Cell Phone(Required)

Email(Required)

CDL(Required)

Yes

CDL Class(Required)

Referred By

General Information

Date you can start(Required)

MM slash DD slash YYYY

Desired Hourly Rate

Are you currently employed?(Required)

Yes

If so, may we contact your current employer?(Required)

Yes

Are you willing to work Saturdays?(Required)

Yes

Please explain whynot(Required)

Are you willing to work 10-hour days?(Required)

Yes

Please explain whynot(Required)

Are you willing to support ground crews when not operating equipment?(Required)

Yes

Please explain whynot(Required)

Are you willing to keep equipment greased and clean the undercarriage daily?(Required)

Yes

Please explain whynot(Required)

Are you willing to train and mentor younger employees?(Required)

Yes

Please explain whynot(Required)

How far are you willing to drive to your jobsite each day?(Required)

Education

High School Name

Years Attended

Date Graduated

Subjects Studied

College Name

Years Attended

Date Graduated

Subjects Studied

Trade School Name

Years Attended

Date Graduated

Subjects Studied

Employment

Employer

Dates From/To

Position

Pay Rate $

Reason for Leaving

Employer

Dates From/To

Position

Pay Rate $

Reason for Leaving

Employer

Dates From/To

Position

Pay Rate $

Reason for Leaving

References (Professional Only)

Name

First Last

Title

Company

Phone

Name

First Last

Title

Company

Phone

Name

First Last

Title

Company

Phone

Heavy Equipment Experience (Answer Only Relative Items)

In what areas of construction have you had sufficient experience?

Articulated Dump Truck

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Dozer

Mass Pushing Skill Level 1-10 (10 being excellent)

Explain your mass pushing experience, and size of equipment you operate:

Fine Grading Skill Level 1-10 (10 being excellent)

Explain your fine grading experience, and size of equipment you operate:

Topsoil Replacement Skill Level 1-10 (10 being excellent)

Explain your topsoil replacement experience, and size of equipment you operate:

GPS Machine Control

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Excavator (Large)

Loading Trucks Skill Level 1-10 (10 being excellent)

Explain your loading trucks experience, and size of equipment you operate:

Digging on Grade Skill Level 1-10 (10 being excellent)

Explain your digging on grade experience, and size of equipment you operate:

Digging for Storm Sewer Skill Level 1-10 (10 being excellent)

Explain your digging for storm sewer experience, and size of equipment you operate:

Excavator (Mini)

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Grader

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Scraper

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Skid-Steer

Task

Skill Level 1-10 (10 being excellent)

Explain your experience, and size of equipment you operate:

Criminal History

Excluding any conviction that has been sealed or expunged, and any minor traffic offenses, in any criminal (misdemeanor or felony) investigation or proceeding, have you ever plead guilty to a crime, or been convicted of a crime, or received a verdict of anything other than ‘not guilty?”(Required)

Yes

If yes, please indicate date and explain the nature of crime. Please also provide any extenuating circumstances or other information, such as rehabilitation since conviction, that would enable the employer to determine your fitness for the job. A conviction is not necessarily a bar to employment.(Required)

Acknowledgement and Authorization

PLEASE READ CAREFULLY BEFORE SIGNING THIS STATEMENT I authorize the Company to investigate all statements in this application and to secure any appropriate information from all of my employers and references, except as I have otherwise indicated in this application. I hereby release all of those employers and references, and the Company from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with the Company. I understand that any offer of employment is contingent upon receipt of a satisfactory check of my academic credentials and employment references. I further understand that any false or misleading statements or material omissions will be sufficient cause for rejection of my application or termination of my employment. I understand that nothing in this employment application is intended to create an employment contract between the Company and me. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless it is made in writing and signed by a Company officer. I understand that if an employment relationship is established, I have the right to terminate my employment at any time for any reason. I also understand that the Company retains the right to terminate my employment at any time for any reason, consistent with applicable law. I hereby acknowledge that I have read and understand this Applicant Statement.(Required)

Yes