Contact Us Get in Touch with Us V Concrete Construction, LLC 7540 N. 67th Ave.PO Box 445Glendale, AZ 85311Phone (623) 518-4797 Fax (623) 518-9582Your comments, questions, and feedback are welcome! APPLICATION FOR EMPLOYMENT 1Applicant2Availability3Experience4Education5Verify6References Date* MM slash DD slash YYYY ATTENTION: (1) Must be at least 18 years old to apply. (2) All questions must be answered. (3) Inaccurate information stated on this application or other hiring forms will disqualify applicant for employment consideration. APPLICANT INFORMATIONName* First Last Address* Address City State ZIP Phone*Email Address* Position(s) Applying For* List any special Skills or Machinery you can operate AVAILABILITYREGULAR PART-TIME WORK?* YES NO REGULAR FULL-TIME WORK?* YES NO WHAT DAYS AND HOURS ARE YOU AVALIABLE FOR WORK?* IF HIRED ON, WHAT DATE CAN YOU START WORKING?* MM slash DD slash YYYY CAN YOU WORK ON THE WEEKENDS?* YES NO CAN YOU WORK EVENINGS?* YES NO ARE YOU AVAILABLE TO WORK OVERTIME?* YES NO Salary Desired: $* EXPERIENCE: LIST PREVIOUS EMPLOYERS, DATING BACK FIVE YEARS, STARTING WITH THE MOST RECENT ONE FIRST Company PhonePosition Held Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Rate of Pay Reason For Leaving IS IT OK TO CONTACT THIS EMPLOYER TO VERIFY EMPLOYMENT? YES NO Company PhonePosition Held Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Rate of Pay Reason For Leaving IS IT OK TO CONTACT THIS EMPLOYER TO VERIFY EMPLOYMENT? YES NO EDUCATION / TRAINING High SchoolSchool Name Address School Address School City State ZIP Number of Years Completed Did You Graduate? YES NO Degree / Diploma Earned College / UniversitySchool Name Address School Address School City State ZIP Number of Years Completed Did You Graduate? YES NO Degree / Diploma Earned Vocation SchoolSchool Name Address School Address School City State ZIP Number of Years Completed Did You Graduate? YES NO Degree / Diploma Earned MilitaryBranch Ranking In Military Total Years of Service Skills / Duties Related Details PERSONAL INFORMATION If hired, would you be able to present evidence of your U.S. Citizenship or proof of your legal right to work in the United States?* YES NO Have you ever worked for V Concrete Construction before?* YES NO If YES, Explain and include datesIf hired, would you have transportation to/from work?* YES NO Are you over the age of 18? ( If under 18, hire is subject to verification of minimum legal age.)* YES NO Are you able to perform the essential functions of the job for which you are applying, either with/without reasonable accommodation?* YES NO If NO, Describe the functions that cannot be performed:*Have you ever been convicted of a criminal offense ( Felony or Misdemeanor)* YES NO If YES, Please describe the crime - state nature of the crime (s), when and where convicted and disposition of the case* REFERENCES List below two persons who have knowledge of your work performance within the last four years. Please include professional references only.Name Telephone NumberAddress Address City State ZIP Occupation Number of Years Acquainted Name Telephone NumberAddress Address City State ZIP Occupation Number of Years Acquainted PLEASE READ AND INITIAL EACH PARAGRAPH I CERTIFY THAT I HAVE NOT PURPOSELY WITHHELD ANY INFORMATION THAT MIGHT ADVERSELY AFFECT MY CHANCES FOR HIRING. I ATTEST TO THE FACT THAT THE ANSWERS GIVEN BY ME ARE TRUE & CORRECT TO THE BEST OF MY KNOWLEDGE AND ABILITY. I UNDERSTAND THAT ANY OMISSION (INCLUDING ANY MISSTATEMENT) OF MATERIAL FACT ON THIS APPLICATION OR ON ANY DOCUMENT USED TO SECURE EMPLOYMENT CAN BE GROUNDS FOR REJECTION OF APPLICATION OR, IF I AM EMPLOYED BY THE V CONCRETE CONSTRUCTION, LLC, TERMS FOR MY IMMEDIATE TERMINATION FROM THE COMPANY. I UNDERSTAND AND THAT IF I AM EMPLOYED, MY EMPLOYMENT IS NOT DEFINITE AND CAN BE TERMINATED AT ANY TIME EITHER WITH OR WITHOUT PRIOR NOTICE AND BY EITHER ME OR V CONCRETE CONSTRUCTION, LLC. I PERMIT V CONCRETE CONSTRUCTION, LLC TO EXAMINE MY REFERENCES, RECORDS OF EMPLOYMENT, EDUCATION RECORD, AND ANY OTHER INFORMATION I HAVE PROVIDED. I AUTHORIZE THE REFERENCES I HAVE LISTED TO DISCLOSE ANY INFORMATION RELATED TO MY WORK RECORD AND MY PROFESSIONAL EXPERIENCES WITH THEM, WITHOUT GIVING ME PRIOR NOTICE OF SUCH DISCLOSURE. IN ADDITION, I RELEASE V CONCRETE CONSTRUCTION, LLC., MY FORMER EMPLOYERS & ALL OTHER PERSONS, CORPORATIONS, PARTNERSHIPS & ASSOCIATIONS FROM ANY & ALL CLAIMS, DEMANDS OR LIABILITIES ARISING OUT OF OR IN ANY WAY RELATED TO SUCH EXAMINATION OR REVELATION.