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Employment Application

    • Personal Data

    • Full Name

    • Social Security Number

      (*not necessary to apply but required for employment)

    • Address

    • Cell Phone

    • Email Address

    • Position(s) Applied For:

    • Are you 18 years of age or older?

    • YesNo
    • **If under 18, we need you to furnish us with a working permit.**

    • Are you legally authorized to work in the United States?*

      YesNo

    • Date available for employment

    • Are you able to meet the attendance requirements of the position?

    • YesNoN/A

    • Will you work overtime if asked?

    • YesNo

    • Have you ever been convicted of any crime, the record of which has not been expunged and that is other than a minor traffic violation?

    • YesNo
    • * Blair Construction is a drug free company and all applicants will be subject to a pre-employment urine analysis for the final hiring process.

    • Special Skills & Qualifications:

    • Desired Rate of Pay

    • Education

    • Highschool

    • Other

    • References

    • Reference 1
    • Reference 2
    • Reference 3

    • Employment History

    • Your present or most recent employer

    • Employment Dates

    • Previous Employer

    • Employment Dates

    • List any other jobs not covered above

    • Please Read Carefully

    • The facts set forth in my application are true and complete. I authorize the investigation of all statements contained in this application and hereby authorize my former employers to furnish all information pertaining to my work record. I hereby release my former employers from all liability on account of furnishing such information. I understand that if employed, false statements, omissions or misleading statements on this application shall be considered sufficient cause for dismissal and I agree that my employer shall not be held liable in any respect if my employment is terminated because of such omissions or false or misleading statements. Omni Resource, Inc./Blair Construction, LLC is hereby authorized to investigate my employment history, including the contacting of the employers listed on the previous page. (If there is a particular employer you do not wish contacted, please indicate which one and why.)

    • Signature

    • Date