Testing Form – Inland Northwest Precast

Your Personal Information

Your Name(Required)

First Middle Last

Your Email Address(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Phone(Required)

Current Skills and Experience

Classification Experience

Indicate the areas in which you have experienced or can operate equipment at an efficient and productive speed

Loader

Backhoe

Dozer

Grader

Paver / Screen

Roller

Raker

Laborer

Flagger

Crusher

Asphalt Plant

Mechanic

Welder

Carpenter

Concrete

Clerical

Dispatch

Electrician

Estimator

Drafting

Purchasing

Dump Truck

Truck & Trailer

Ready Mix Truck

Classification Details

For every classification you marked above, please Indicate the following details of that experience. (Click the + Symbol to add a new row)

Classification

Certification (Yes or No)

Models or Brands

Duration (Years)

Summarize special skills and qualifications not listed above

Or state any additional information you feel may be helpful to us in considering your application.

Previous Employment

Your Previous Employers

Please list your previous employers, the dates you worked and the position you held. (Click the + Symbol to add a new row)

Employer

Dates

Position

Phone

Comments

Comments, including any explanations of any gaps in employment.

Are you now or do you expect to be engaged in any other business or employment? Yes No

Please explain why you said yes.

References(Required)

Give name, address and telephone number of three references who are NOT related to you and are not previous employers. (Click the + Symbol to add a new row)

Reference Name

Reference Number

Reference Address

What date would you be available for work?(Required)

MM slash DD slash YYYY

May we contact your present employer?(Required)

If currently employed

Yes

Are you willing to work overtime if job requires it?(Required)

Yes

Are you willing to relocate if job requires it?(Required)

Yes

Do you have your CDL?(Required)

Yes

Do you have a first aid card?(Required)

Yes

Have you ever been convicted of a felony?(Required)

Yes

Please explain

Such convictions may be relevant if job related, but does not bar you from employment. If yes, please explain.

More About You

Education

Please tell us your educational history including highschool, GED's and college. (Click the + Symbol to add a new row)

School Name

Diploma/Degree

Course of Study

Specialized Training

Tell Us About Yourself

Upload Your Resume

Upload your resume in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

Applicant's Statement(Required)

I ACKNOWLEDGE THAT EMPLOYMENT IS CONTINGENT UPON BEING ABLE TO PROVE MY ABILITY TO LEGALLY WORK IN THE UNITED STATES.

THE INFORMATION PROVIDED IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT A
MISREPRESENTATION OR OMISSION BY ME ON THIS APPLICATION OR DURING THE INTERVIEW PROCESS WILL BE CAUSED
FOR CANCELLATION OF THE APPLICATION OR DISMISSAL, IF EMPLOYED.

I AUTHORIZE THE COMPANY TO VERIFY THE INFORMATION CONTAINED IN THIS APPLICATION. I FURTHER AUTHORIZE AND
REQUEST THAT ALL OF MY PRESENT AND FORMER EMPLOYERS AND THOSE INDIVIDUALS I HAVE LISTED AS PERSONAL
REFERENCES FURNISH INFORMATION ABOUT MY EMPLOYMENT RECORD, INCULDING A STATEMENT OF THE REASON FOR
THE TERMINATION OF MY EMPLOYMENT, WORK PERFORMANCE, ABILITIES, AND OTHER QUALITIES PERTINENT TO MY
QUALIFICATIONS FOR EMPLOYMENT, HEREBY RELEASING THEM FROM ANY AND ALL LIABILITY FOR DAMAGES ARISING
FROM FURNISHING THE REQUESTED INFORMATION.

I ALSO UNDERSTAND THAT I WILL BE REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF EMPLOYER AS THEY
NOW EXIST AND AS THEY ARE AMENDED FROM TIME TO TIME AT THE COMPANY'S SOLE OPTION. ANY OFFER I RECEIVE
FROM THE COMPANY IS CONTINGENT UPON MY SUCCESSFUL COMPLETION OF THE COMPANY'S TOTAL PRE-EMPLOYMENT
SCREENING PROCESS. I ACKNOWLEDGE THAT FOR CERTAIN JOBS I MAY BE REQUIRED TO SUBMIT TO PRE-EMPLOYMENT
DRUG TESTING AND/OR TO TAKE A PHYSICAL. COMPLIANCE IS A REQUISITE FOR EMPLOYMENT.

I UNDERSTAND THAT I WILL NOT HAVE A CONTRACT OF EMPLOYMENT BETWEEN MYSELF AND THE COMPANY, FOR ANY
SPECIFIED PERIOD OF TIME. I ALSO UNDERSTAND THAT SUBJECT TO APPLICABLE LAWS, THE EMPLOYMENT RELATIONSHIP
IS AN "AT WILL" RELATIONSHIP. AS SUCH, IT MAY BE TERMINATED BY MYSELF, OR BY THE COMPANY, AT ANY TIME,
FOR ANY REASON AND WITH OR WITHOUT NOTICE. THIS APPLICATION IS NOT AN OFFER OF EMPLOYMENT.

I agree to the terms and conditions.

Signature(Required)