7135 5th Ave N.E.
Sauk Rapids, MN 56379
320.393.3185
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Date
First Name
Last Name
Middle Name
Address
City
State
Zip
Telephone Number
Email
Positions Applied For
Pay expected
When would you be available to begin work?
Have you ever been employed with us before? If yes, when?
Are you currently employed?
Are you 18 years or older? Yes
No
Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant).
Have you ever had any job-related training in the United States military? If yes, please describe.
How did you learn about us? Advertisement
Employment Agency
Walk-in
Friend
Relative
Other
Record of Education
High School
Circle last year completed 1
2
3
4
Course of Study
Did you Graduate? Yes
No
List Diploma or Degree
 
College
Circle last year completed 1
2
3
4
Course of Study
Did you Graduate? Yes
No
List Diploma or Degree
 
Other (Specify)
Circle last year completed 1
2
3
4
Course of Study
Did you Graduate? Yes
No
List Diploma or Degree
Employment Experience
Current, Last Employer
Length of service
Work performed
Employer Street Address
Employer City
State
Employer Zip
Telephone number
Job title
Supervisor
Salary: Start to Finish
Reason for leaving
Employer
Length of service
Work performed
Employer Street Address
Employer City
State
Employer Zip
Telephone number
Job title
Supervisor
Salary: Start to Finish
Reason for leaving
I hereby give permission to contact the employers listed above concerning my prior work experience. Signature
If there is a particular employer(s) you do not wish us to contact, please indicate which ones.
Please read & sign the Applicant’s Statement on the next page of this Application.
Applicant's Statement
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name and address of the agency so I may obtain from them the nature and substance of the information contained in the report. I understand that any offer of employment, which I may receive, is contingent upon my successful completion of a blood and/or urine drug screen. If hired, submission to drug and/or alcohol testing may be required as a condition of employment. Refusal to submit to such testing during the course of employment may result in disciplinary action, up to and including termination. I understand that neither this document nor any offer of employment from Boser Construction, Inc. constitutes an employment contract unless a specific document to that effect is executed by the President of Boser Construction, Inc. and myself in writing. I understand that any offer of employment is contingent upon my signing an employment agreement. In the event of employment, I understand that false or misleading information given in my application, resume (if any), or interview(s) may result in termination. I understand also, that I am required to abide by all rules and regulations of Boser Construction, Inc. I understand and acknowledge that if hired, my employment is at-will and may be terminated at any time by Boser Construction, Inc. or myself.
I have read the above statement and accept the same as a condition of my employment with the company. Yes
No
Signature of Applicant
Date



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