Z-MAN CONSTRUCTION
EMPLOYMENT APPLICATION

WE ARE A DRUG FREE WORKPLACE
WE DO RANDOM DRUG TESTING

An Equal opportunity Employer
*We consider applicants for all positions without regard to race, color, sex, religion, national origin, age, marital or veteran status, the presence of non-job related medical conditions or disabilities or any other legally protected status.

1. Name:  Date:
2. Address:  City: State: Zip:
3. Home phone:  Work Phone: SSN:
4. Email:
5. Position for which you are applying
6. Lowest acceptable wage $ per hour    Date you can start:
7. Are you available to work: Full-time Part-time Temp Days Evenings Weekends All
8. Referred by: Newspaper Ad Recruited Walk-In Website Other
9. Are you legally eligible to hold employment in the United States: Yes No
10. Are you at least 18 years old? Yes No   If no, birth date:
11. Are you related to anyone employed by Z-MAN Construction Yes No
12. Have you ever worked for Z-MAN Construction. Yes No If yes give date
    Location: Supervisor's name:

13. EDUCATION

Are you capable of satisfactorily performing the essential job duties required for the position for which you are applying? Yes No
Have you ever been terminated or asked to resign from any job?  Yes No
If yes, please explain circumstances:
Do you have adequate transportation to and from work?  Yes No

14. List any additional or special education, training, skills or machines operated:
15. Have you ever been convicted (found guilty) of attempting or committing any crime other than a minor traffic violation?
    Yes No    If yes, when? For what?
    Have you been arrested for any matters for which you are out on bail or your own recognizance pending trial? Yes No
    If yes, when? For what?

Note:  A conviction record will not necessarily bar individuals from employment.  You are not required to reveal records that have been judicially expunged, sealed or eradicated.

Note: Applicant to pay for Mandatory Drug Test ($50.00) which will be refunded upon being hired (after 60 day probationary period).

List all former and current employers in reverse order.  Give present or most recent employer first.  Include any periods of unemployment, self-employment, military service, etc.  Information provided is subject to verification.

A resume MAY NOT be submitted as a substitute to filling out this section
Company Name: Position/Title:

Address: City State Zip
Dates Employed:  From to
Supervisor's Name: Title: Ph.No.
Starting rate of pay:$ per Last rate of pay:$ per
Responsibilities:
Reason for leaving:
If time elapsed between positions, please explain:

Company Name: Position/Title

Address: City State Zip
Dates Employed:  From To
Supervisor's Name: Title: .Ph.No.
Starting rate of pay:$ per Last rate of pay$ per
Responsibilities:
Reason for leaving:
If time elapsed between positions, please explain:

Company Name: Position/Title

Address: City State Zip
Dates Employed:  From To
Supervisor's Name: Title: Ph.No.
Starting rate of pay:$ per Last rate of pay:$ per
Responsibilities:
Reason for leaving:
If time elapsed between positions, please explain:

Immigration Act

I understand that, if hired, I will be required to offer examination documents proving that I am a United States citizen or an alien currently authorized to Work in the United States, I also understand that my continued employment is contingent upon my proving the necessary documentation within the prescribed time frames.

Acknowledgement: Date
                                Applicant's Signature
READ CAREFULLY BEFORE SENDING

I hereby certify, to the best of my knowledge, that the answers given are true and complete. I also understand that an omission or falsification may disqualify me from consideration for employment or may be grounds for my immediate dismissal. I agree to conform to the rules and regulations of the company and, if employed, I understand and agree that my employment is at-will and that no employment contract rights have been created. I also understand and agree that my employment may be terminated at any time with or without cause and with or without advance notice at the option of either the company or myself.
I understand that no supervisor, manager or other representative of the company has any authority to enter into any express or implied contract for employment for any specific period of time.; Any agreement contrary to the above must be in writing and expressly state that it is a contract and be signed by the authorized representative of the company. I agree to a physical examination, if requested, and understand that failure to meet any medical and/or health requirements for the position will prevent my employment with the company. I also understand that employment, for certain positions, and is conditional upon successful completion of a substance abuse screening test as part of the company's pre-employment policy.

This application will remain active for 3 months. Applicants who wish to be considered after that time must reapply.

by submitting this application you agree to the above statement.