Abfalter Brothers Concrete
15546 Cleveland St. NW
Elk River, MN 55330
Phone: 763-635-8088

APPLICATION FOR EMPLOYMENT

Personal Information

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Address
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Non US Number
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Phone #:
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(000) 000-0000
2nd Phone #:
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(000) 000-0000
Email:
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Pay Expected:
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Date Available for Work:
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Addresses lived for the Past 3 Years

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General Information

I am applying for: General Construction Position Truck Driving Position

How did you learn about us?









Employee Referral Name:    Other:   
Have you ever been employed with Midwest Mobile Mix or Abfalter Concrete?

   

If yes, give Date: Invalid format.Position: Location:
Are you legally eligible for employment in the United States?

      

You must be 18 years of age or older to work in the highway/heavy industry. Are you of age to work in this industry?

     

Are you willing/able when the job requires to travel by personal vehicle?

     

Jobs may require overtime. Are you willing to work overtime if needed?

     

Projects may require working nights. Are you willing/able to work nights if jobs require?

     

Are there specific shifts you are available to work or prefer to work?

     

If yes, specify shifts:
Saturday or Weekend work may be required. Are you willing to work Saturdays or Weekends if needed?

     

Type of Employment Desired?

Year Round           Seasonal           Part-Time/Temporary and dates available:   
    to  

Can you perform the essential functions of this job?

     

Education/Training

Name
City & State
Major
Years
Completed
Degree
Achieved
HS/GED
Trade / Technical
College / University
Graduate or Professional

Employment Experience

 

A RESUME MAY BE ATTACHED BUT IS NOT ACCEPTABLE IN LIEU OF COMPLETING THIS APPLICATION. List your last ten (10) years of employment, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps i the comments section below.

You may exclude experiences which reveal age, ancestry, disability, national origin, race, religion, sex or other protected status.

Previous Employer
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Work Performed:
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Work Performed:
Reason for Leaving:

May we Contact your current and previous employers?      

If NO, please explain:

Other Comments / Information (Gaps of Employment)

What interests you about this position?

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Please identify experience you have in the following areas:

Truck Driving Positions Type of Equipment Duration of Experience
(Months/Years)
Tractor-Trailer
Dump Truck
Ready Mix Truck
Boom Truck
Equipment Operator Positions Type of Equipment Duration of Experience
(Months/Years)
Backhoe
Bobcat
Crusher
Dozer
Farm Tractor
Forklift
Loader
Motor Grader Finish    
Packer (tractor)
Paver
Paver/Screed
Roller
Screen Plant
Washplant
Asphalt Plant
Labor Positions Type of Experience Duration of Experience
(Months/Years)
Laborer (common)
Laborer (concrete)
Laborer (gravel)
Laborer (paving)
Flagger Certification   
Raker
Carpenter
Maintenance Positions Type of Experience Duration of Experience
(Months/Years)
Mechanic
Welder Certification      
Electrician License Type:
Parts Dept
Other Positions    
Estimator
Drafting
Dispatch
Clerical
Purchasing
Summarize any additional training, skills, licenses and/or certifications that may qualify you as being able to perform job-related functions in the position for which you are applying.

Driver Information

Authorization is Required.I authorize the release of my employment driving record including drug test results to be reported to Abfalter Brothers Concrete
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State:
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Conviction Information

Have you ever been convicted of a felony?      

(A conviction will not necessarily bar you from employment. This information will be used only for job-related purposes in accordance with applicable law. Do no disclose convictions that have been expunged or judicially sealed.)

I you selected Yes to the last question, provides Dates & Locations:


Professional References (not relatives or previous employers)

Name Company/Location Relationship Phone
(000) 000-0000
Non US Number?
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Attachments

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**Valid files for attaching to your application include: .txt   .doc   .docx   .pdf

Applicant's Statement

Midwest Mobile Mix is an equal opportunity employer, and selects the best matched individual for the job based upon job-related qualifications, regardless of race, color, religion, national origin, gender, disability, age, marital status, veteran status, creed, status with regard to public assistance, sexual orientation, or other legally protected status under state, federal or Equal Opportunity laws.

I understand and agree that:

  1. Although management makes every effort to accommodate individual preferences, business needs may at any time make the following conditions mandatory: overtime, shift work, weekend or evening work.
  2. I understand that if I am employed at a division within an "at will" state, such employment is for no definite period of time and that Abfalter Brothers Concrete can change wage, benefits and employment conditions at any time. If employment with this organization is at a division within an "at will" state, the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. Not all divisions are located in "at will" states.
  3. If a job offer is made by the company, I agree to submit to a post-offer, pre-employment physical examination, fit for duty test and drug screening test as a condition of employment. I understand that an offer of employment is conditioned upon the results of said testing being satisfactory to the company.
  4. If I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer's service, whenever it is discovered.
  5. My signature authorizes Abfalter Brothers Concrete to make such investigation and inquiries of my personal, employment and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools or persons from all liability in responding to inquiries in connection with my application. I authorize said companies, schools or persons named in this employment application to release information regarding my employment, academic records, character and qualifications.
  6. in the event of employment, I understand that false or misleading information given in my application(s) or interview(s) may result in my discharge. I understand, also, that I am required to abide by all rules and regulations of Abfalter Brothers Concrete as permitted by law.
  7. I authorize said companies to release information from by DOT regulated drug & alcohol testing records. I authorize release of alcohol tests, positive drug tests, refusals to test, other violations of DOT agency regulations, documentation of completion of the return-to-duty following a rule violation, any other information obtained from previous employers of a drug & alcohol rule violation.
  8. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as require by 49CFR 391.23(d) and (e).
  9. I understand that I have the right to review information provided by current/previous employers, have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer, and have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.
  10. I understand that nothing contained in this employment application or in the granting of an interview creates a contract between Abfalter Brothers Concrete and me for employment or for any other benefit. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon Abfalter Brothers Concrete

Agree and Certify is Required.I HAVE READ AND UNDERSTAND THE ABOVE. I ALSO CERTIFY THAT ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

KEYING YOUR NAME BELOW AS IT APPEARS ON THIS DOCUMENT IS EQUIVALENT TO SIGNING YOUR NAME TO THIS DOCUMENT AND THEREFORE CONVEYS YOUR ACKNOWLEDGEMENT AND AUTHORIZATION OF THE ABOVE STATEMENTS.

FULL NAME AS ENTERED ON THIS FORM:

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THE COMPANY IS AN EQUAL OPPORTUNITY EMPLOYER

Abfalter Brothers Concrete is an Equal Opportunity Employer and has adopted an Affirmative Action Program to provide equal employment opportunity in all personnel activities without regard to race, religion, color, sex, age, disability, national origin or status as a disabled veteran or veteran of the Vietnam Era. Abfalter Brothers Concrete provides reasonable accommodations to qualified individuals with disabilities, in accordance with the Americans with Disabilities Act and applicable state and local laws.

 

 

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