Let Us Know About You Basic Information First Name Middle Initial Last Name Email Phone Address Apt/Unit City State Zip Important Details Date of Birth Do you have a valid drivers license? Y N Are you a U.S. Citizen? Y N If not, are you authorized to work in the U.S.? Y N Have you every been convicted of a felony? Y N Do you have experience operating heavy equipment? Y N Education High School Name of School City, State Years Attended Did you graduate? Y N College / Higher Learning Name of School City, State Years Attended Degree Earned Did you graduate? Y N Add Another Degree Work History Employer 1 Company Name City, State Starting Date Salary Ending Date Salary Job Title Supervisor Phone Can we contact your previous supervisor for a reference? Y N I don't have any work history Add Another Employer References Please add as many references as you have available. Reference 1 Name Phone Company Relationship Add Another Reference Military Service Did you serve in the Military? Branch Years Of Service Rank at Discharge Type Of Discharge Other Details Would you like to tell us other relevant information about yourself? Disclaimer and Signature Please read and acknowledge before submitting this application. I acknowledge my answers to the information entered is true and complete to the best of my knowledge. I understand I must have a current driver's license and be able to pass a drug screening before being eligible for employment with Baker & Company Construction, LLC. If this application leads to employment, I understand false or misleading information given in this application or during the interview process can/will result in my release of employment with Baker & Company Construction, LLC. I understand and acknowledge the previous statement. Typed Signature Date Submit Application Success! Unsuccessful!