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Simonds Construction Illini Asphalt Kinkaid Stone Anna Quarries About Recycling Recycling Video Asphalt Plant Locations Equipment For Sale Safety Careers FAQ Apply Online Contact Employment Application Step 1 of 5 20% PERSONAL INFORMATIONDate of Application MM slash DD slash YYYY Name* First Last Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Position Desired*Operations ManagerPlant SupervisorTrucking SupervisorCost AccountantTruck DriverCan you perform the essential functions of the position for which you are applying? Yes No If no, please explain. (If you have questions as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question.)Date you are available to begin work:* MM slash DD slash YYYY Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment.) Yes No Are you over the age of 18 years?* Yes No Have you ever worked for this company before?* Yes No If yes, when and what was your title? Have you ever done any volunteer work?* Yes No Please describe the volunteer work you have done in the past. (Omit any volunteer work which reflects your race, color, religion, age, sex, sexual orientation, marital status or disabilities.)Are you able to work (check all that apply):* Select All Days Nights Weekends Full-Time If you cannot work full-time, please explain why.Days and hours available? (If employed, notification must be provided in writing should your availability change.)*SundayMondayTuesdayWednesdayThursdayFridaySaturday Are you presently employed?* Yes No If yes, may we contact your employer? Yes No If you are presently employed, why are you considering leaving?Do you belong to any professional, trade, business or cific organizations that deal with the position for which you are applying?* Yes No If yes, please explain and list offices held. (Omit any organization which reflects your race, color, religion, age, sex, sexual orientation, marital status, or disabilities.) EDUCATIONHigh School Education/GED*Name and Location of SchoolCourse of Study# Years CompletedDiploma or Degree Rec'd College EducationName and Location of SchoolCourse of Study# Years CompletedDiploma or Degree Rec'd Vocational or Trade School EducationName and Location of SchoolCourse of Study# Years CompletedDiploma or Degree Rec'd Graduate WorkName and Location of SchoolCourse of Study# Years CompletedDiploma or Degree Rec'd Have you completed any special courses, seminars and/or training directly related to the positions for which you are applying?* Yes No If yes, please describe.Please list academic honors, extracurricular activities, offices held, etc in high school or college. (Omit any which reflects your race, color, religion, age, sex, sexual orientation, marital status or disabilities.) EMPLOYMENTPlease provide your employment history starting with your most recent employer. Name of Employer Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneName Of Supervisor First Last Dates of EmploymentFrom (Month/Day/Year)To (Month/Day/Year) Describe the work performed.Name of Employer Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneName Of Supervisor First Last Dates of EmploymentFrom (Month/Day/Year)To (Month/Day/Year) Describe the work performed.Name of Employer Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name Of Supervisor First Last PhoneDates of EmploymentFrom (Month/Day/Year)To (Month/Day/Year) Describe the work performed. PERSONAL REFERENCESPlease provide two personal references who are not relatives or former employers.Reference Type:*PersonalBusinessName of Reference #1* First Last Reference #1's Occupation* Reference #1's Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #1's Phone Number*Reference Type:*PersonalBusinessName of Reference #2* First Last Reference #2's Occupation* Reference #2's Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #2's Phone Number* EEO STATEMENTWe are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.Important. Please read and Acknowledge* I agree to the Application for Employment Policy.I understand that failure to reveal any prior employer or giving false or misleading information by me or any part of this Application for Employment can result in disqualification for employment consideration or, if hired, may be grounds for termination from the company or its' subsidiaries. I understand that if I am hired, my employment is for no definite time and may be terminated at any time without prior notice. 2016 © E.T. Simonds Materials, All rights reserved. HOME ABOUT SHINGLE RECYCLING RECYCLING VIDEO ASPHALT PLANT LOCATIONS EQUIPMENT FOR SALE SAFETY CAREERS CONTACT GET A QUOTE
