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Applicant Information

Employment Position

Personal Information

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense.  The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to position(s) applied for may, however, be considered.)

Job Skills/Qualifications

(Note: D and J Sand & Gravel complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)

Education and Training

Military

Previous Employment

References

Additional Information

I certify that I have given true, accurate and complete information on this form to the best of my knowledge.  In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal action. I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications.