Application for Employment

Personal Information

Name (Last, First Middle)

 

Social Security Number

Address

 

State

Zip

Date of Birth

 

Place of Birth (City, State, Country)

Phone Number

 

Desired Employment

Position

 

 

 

 

 
Are you Employed Now?

                                                                                        Yes              No

 

 

 

 
Ever Applied to Silva General

Construction before?                                                   Yes              No

 

 

 

 
Ever Worker to Silva General

Construction before?                                                   Yes              No

Reason For Leaving Previous Job

 

 

 

Name of Last Supervisor

 

Who referred you to Silva General Construction?

 


 

Education

School Level

Name & Location of School

# of Yrs Attended

Did you graduate?

Subjects Studied?

 

Grammar School

 

 

 

 

 

High School

 

 

 

 

 

College

 

 

 

 

 

Trade or Business School

 

 

 

 

 

Military

 

 

Discharge Date

Rank

 

 

 

 

 

 

 
Have you been convicted of a felony within the last 5 years?

                                                                                                                                      Yes                     No

If so, please explain:

 

 

 

 

 

 

 

Experience

Company Name

 

Job Title

Wages

$_____________ / hour

# of Yrs with Company

Job Description:

 

 

 

 

Company Name

 

Job Title

Wages

$_____________ / hour

# of Yrs with Company

Job Description:

 

 

 

 

Company Name

 

Job Title

Wages

$_____________ / hour

# of Yrs with Company

Job Description:

 

 

 

 

References

Name

Address

Business / Trade

Years Acquainted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

 

 I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information. 

 

I also understand and agree that no representative of the company has any authority to enter into any agreement employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.”

 

 

___________________________________________________________________________________________________________________________________

Date                                                                                     Signature

 


IRS W-4 Form:

www.irs.gov/pub/irs-pdf/fw4.pdf