Employment Application As an equal opportunity employer, SSC, does not discriminate in hiring because of an individual’s age, race, gender, color, religion, national origin, disability, marital status, veteran status, or any other characteristic protected under federal, state, or local laws. SSC hires only individuals authorized for employment in the United States.
Today’s Date:
Personal Information Last Name: First Name: Middle Initial: Present Address: City: State: Zip: Home Phone Number: Cell Phone or Message Phone: Email Address: Social Security Number: Are you at least 18 years of age? Choose one No Yes Are you a U.S. citizen or an Alien authorized to work in the United States? Choose one No Yes Position Desired What position are you applying for? Employment Desired: Choose one Full Time Part Time What salary do you expect? Date available to start? Employment History Please list your employment history beginning with your most recent position
Education PlPlease provide information about your highest level of education
Miscellaneous Do you have a valid driver’s license? Choose one No Yes (you are not required to answer unless driving is necessary in the job for which you are applying). License #: State: Expiration: Do you have any moving violations? Choose one No Yes Have you been involved in an accident in the last 5 years? Choose one No Yes How were you referred to SSC? Have you ever applied with SSC before? Choose one No Yes If so, when? Have you been terminated from any job for any reason? Choose one No Yes If yes, please explain: Do you have any limitations that would prevent you from lifting 70 lbs. or more? Choose one No Yes If yes, please explain: Please list any additional skills or training that would be useful for the job for which you are applying, include additional languages you speak fluently:
Please Read This Statement Carefully Release Agreement I authorized you and/or your agents in this release to make such investigations and inquiries of my personal, employment, financial and other related matters as may be necessary for the determination of the initial decision to offer me employment as well as any subsequent employment decision. I also authorized the companies, governmental agencies schools or persons named in my application to give any information regarding my employment, together with any other information they may have regarding me whether or not it is in their records. I hereby release said companies, governmental agencies, schools or persons as well as you and/or your agents from all liability for any damage for issuing or requesting or investigation this matter. I further agree that failure to reveal any prior employment I have had within the past seven (7) years or the giving of any false or misleading information may result in termination of my employment, irrespective of when such false or misleading information might be discovered by the Company. In consideration of my employment, I agree to comply with the policies, rules, regulations and procedures of Specialized Services Company. I understand that I do not have a Contract of Employment with Specialized Services Company; that my employment will be at will and is not for a definite duration; and that my employment can be terminated with or without cause or notice, at any time, at the option of either Specialized Services Company or myself.
By typing in your name you agree to the statement above.
Applicant Signature: Date: EQUIPMENT EXPERIENCE Write down your personal experience operating each specific type of equipment. Please be thorough. 1) Trackhoe/Excavator: Case Model 930 2) Trackhoe/Excavator: Cat Model 325L 3) Backhoe: Case Model 580K with foot swings 4) Other Equipment: List Type and Model
Applicant Signature: Date:
RELEASE AUTHORIZATION Name: (Last) (First) (Middle Initial) Maiden/Previous Name(s) Home Address: (Include City, State Zip code) Social Security Number: Date of Birth: Driver’s License Number: State Issuing: Authorization to Secure Consumer Investigative Report I authorize Specialized Services Company to make whatever inquiries it may deem necessary in connection with my application of employment. As part of such inquiries, the Company has my permission to contact persons who may have information regarding my suitability for employment and to secure consumer reports (including investigative consumer reports). I authorize and instruct any person or agency contacted to participate or conduct inquiries at its request, to compile information, and to furnish any information obtained as a result of such inquiries. I further authorize the Company, in its sole discretion, to furnish copies of this authorization and my application to any person and/or consumer-reporting agency in connection with above purposes. Disclosure Statement Information contained in reports obtained by Specialized Services Company in accordance with above authorization may include information pertaining to your character, general reputation, police record, personal characteristics, and mode of living. You have the right to request that Specialized Services Company completely and accurately disclose to you the nature and scope of all investigations requested. Such a request must be made in writing to the personnel department within a reasonable period of time after your application for employment is received. I hereby acknowledge that I have read the above disclosure statement and have understood it. Applicant Signature: Date: