APPLICATION FOR EMPLOYMENT

Step 1 of 5

S.E.H. Excavating Contractors, Inc. is an equal opportunity employer. We adhere to a policy of making all employment decisions without regard to race, color, sex, religion, national origin, age, disability, veteran status, sexual orientation, citizenship or any other protected classification which may be applicable. Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. This application will remain active for a period of 30 days after the date of application.
Date of Application*
MM slash DD slash YYYY
PERSONAL DATA
Name*
First Last
Home Phone*
Email*
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security No*
Are you under 18 years of age?*
- Yes
- No
How long have you resided at your present address?*
Previous Address
Street Address City State / Province / Region ZIP / Postal Code Country
How long did you reside at your previous address?
List any other name you have used to assist us in checking your references and background
Can you submit verification of your right to work in the U.S.?*
- Yes
- No
Have you ever been CONVICTED of a misdemeanor (other than traffic violation) or a felony that has not been judicially sealed, expunged or pardoned? ( *Conviction of a crime will not necessarily disqualify you from consideration for employment. )*
- Yes
- No
If yes, list nature of offense, dates of conviction and dates of incarceration*

EDUCATION
High School*
From*
Graduate?*
Courses Studied*
College*
Start-End Dates*
Graduate?*
Courses Studied*
Other Education*
Start-End Dates*
Courses Studied*
REFERENCES
Name*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number*
Years known*
Name*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number*
Years known*
Name*
Relationship*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number*
Years known*
SPECIAL SKILLS
Please list any equipment which you are experienced in running*

THIS APPLICATION IS NOT COMPLETE UNTIL SIGNED, AND ALL STATEMENTS BELOW HAVE BEEN READ AND INITIALED
Initial:*
I understand that this application is not intended to create, not should it be construed to create, an express or implied contract of employment. It does not create contractual obligations of any kind. If hired, I will be employed at will; I understand that this means that either I am or the employer is free to terminate the employment relationship at any time with our without cause or prior notice.
Initial:*
I certify that all of the information furnished on this application and during the application process is true, complete and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts called for will result in refusal to hire or, if hired, will result in my dismissal at any time regardless of when the false answer or omissions are discovered.
Initial:*
I authorize the investigation of all matters contained in this application at any time during the course of my employment, including a criminal background check, and hereby give the company permission to contact schools, previous employers, references and others. I hereby release the company and those it contacts from any liability whatsoever as a result of such contact and the information provided and received as a result of such contact. I also understand that the company may cause a consumer credit report to be prepared for employment purposes, and that I have the right to request additional information on the nature of the report.
Initial:*
As a condition of my employment, I hereby agree that if I am offered employment, I will submit to a required medical evaluation at the expense of the company. I understand that any medical evaluation procedure is consistent with the company’s affirmative action commitments to the disabled and consistent with the Americans with Disabilities Act. I further understand that the purpose of the medical examination is solely to determine whether I am able to perform the essential functions of the position offered, with or without any reasonable accommodation.
Initial:*
I understand that the company reserves the right to require me to submit to a test for the presence of any illegal drugs in my system prior to employment and at any time during my employment, to the extent permitted by law. I consent to the disclosure of the results of any such tests to the company and I understand that employment will be denied or terminated if any such test shows the presence of illegal drugs in my system.
Under Maryland law, an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to or take a polygraph, lie detector or similar test on examination as a condition of employment or continued employment. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.
Signature*

DRIVER DISCLOSURE AND RELEASE FORM EMPLOYEE DRIVING RECORD INFORMATION
1. In connection with my employment (or my application for employment), I hereby give permission to SEH Excavating, Inc. ,(hereinafter referred to as Employer) to obtain my state driving record(also known as my motor vehicle record or MVR).
2. I acknowledge and understand that my driving record is a consumer report that contains public record information.
3. I authorize, without reservation, any party or agency contacted by Employer, to furnish the above-mentioned information.
4. I understand that I have the right to request a copy of my driving record and to know the source or sources of my driving record, for a two-year period preceding my request.
5. This authorization shall remain on file by Employer for the duration of my employment, and will serve as ongoing authorization for Employer to procure my state driving record at any time during my employment period.
6. I understand that Employer may take adverse action affecting my employment, based on information in my driving record. If such adverse action is taken, I acknowledge that my rights are as follows:
- Employer must notify me in writing of any such adverse action.
- I have the right to receive a copy of the driving record upon which the adverse action was based.
- I have the right to receive a summary of my rights under the Fair Credit Reporting Act. I have the right to know the name, address, and phone number of the consumer reporting agency that provided my driving record to employer.
- I have the right to obtain a free copy of my driving record from the agency that provided it, if such request is made within 60 days from the date that Employer took adverse action.
- I have the right to dispute the accuracy or completeness of my driving record with the consumer reporting agency that provided it, and request that errors be corrected.
Employee’s Name (Print)*
Date of Birth*
MM slash DD slash YYYY
Employee’s Signature*
Social Security Number*
Driver’s License Number & State*

APPLICATION FOR EMPLOYMENT

Step 1 of 5

PERSONAL DATA

Drivers License

EMPLOYMENT DESIRED

PREVIOUS EMPLOYMENT

EDUCATION

REFERENCES

SPECIAL SKILLS

THIS APPLICATION IS NOT COMPLETE UNTIL SIGNED, AND ALL STATEMENTS BELOW HAVE BEEN READ AND INITIALED

DRIVER DISCLOSURE AND RELEASE FORM EMPLOYEE DRIVING RECORD INFORMATION