Employment Application Personal DataFull NameSocial Security NumberAddressCell PhoneEmail AddressPosition(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?*YesNoDate available for employmentAre you able to meet the attendance requirements of the position?YesNoN/AWill you work overtime if asked?YesNoHave you ever been convicted of any crime, the record of which has not been expunged and that is other than a minor traffic violation?YesNoSpecial Skills & Qualifications:EducationHighschoolOtherReferencesReference 1Reference 2Reference 3Employment HistoryYour present or most recent employerEmployment DatesPrevious EmployerEmployment DatesList any other jobs not covered abovePlease Read CarefullyThe 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.)SignatureDate