Employment Application

Employment application (non-driver/non-DOT)

Delaware Valley Concrete is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

If you are unable to use our online application process due to an impairment or disability, please contact Human Resources Department at hr@delvalconcrete.com or 215-675-8900 ext. 135

Employment with Delaware Valley Concrete will require successful completion of background check(s) in accordance with company policies.

Delaware Valley Concrete, Inc. participates in the federal government’s E-Verify program. With E-Verify we are able to confirm the employment authorization of all newly hired employees through an electronic database maintained by the Social Security Administration and Department of Homeland Security. With respect to new hires, the E-Verify process is completed in conjunction with a new hire’s completion of the Form I-9, Employment Eligibility Verification upon commencement of employment. E-Verify is not used as a tool to pre-screen candidates. For up-to-date information on E-Verify, go to www.uscis.gov and click on the ‘E-Verify’ logo.

APPLICANT INFORMATION

Today's date

Name

Last

First

Middle

Phone

Email address

Position applying for

Desired salary

Permanent Address

Street

City

State

Zip code

How were you referred to Delaware Valley Concrete?

If other:

Employment desired:

Are you available to work weekends? YesNo

Are you 18 years of age or older? YesNo

Have you ever applied to this company before? YesNo

If yes, when?

Have you ever worked at this company before? YesNo

If yes, when?

Have you ever been convicted of a felony? YesNo

If yes, please explain the nature of the felony, the date it was committed, and the state where it occurred. Conviction of a felony is not an automatic bar to employment, since the date, nature of the felony, and job to which you are applying will be considered.

If yes, please explain:

EDUCATION

School	Name and location	Number of years attended	Major	Diploma or degree received
High school or GED
College
Graduate
Technical or vocational

TRAINING COURSES

List any relevant academia honors, awards, scholarships, professional organizations, volunteer activities, certificates, publication, licenses or any other information considered significant and relevant to employment:

Course/seminar	Organization	Content	Date(s) attended

EMPLOYMENT HISTORY

List your work experience for the past ten years, beginning with your most recently held job. If more space is required, please send an email to hr@delvalconcrete.com

EMPLOYER

NAME

ADDRESS

CITY, STATE, ZIP

Supervisor name

Description of duties

DATE

FROM:

TO:

Ending salary

May we contact this employer? YesNo

Reason for leaving

EMPLOYER

NAME

ADDRESS

CITY, STATE, ZIP

Supervisor name

Description of duties

DATE

FROM:

TO:

Ending salary

May we contact this employer? YesNo

Reason for leaving

EMPLOYER

NAME

ADDRESS

CITY, STATE, ZIP

Supervisor name

Description of duties

DATE

FROM:

TO:

Ending salary

May we contact this employer?YesNo

Reason for leaving

EMPLOYER

NAME

ADDRESS

CITY, STATE, ZIP

Supervisor name

Description of duties

DATE

FROM:

TO:

Ending salary

May we contact this employer? YesNo

Reason for leaving

PROFESSIONAL AND BUSINESS REFERENCES

Name & business relationship	Phone number

MILITARY SERVICE

Branch of service

Date entered

Date discharged

Nature of duties, special skills, training, etc.

PLEASE READ CAREFULLY BEFORE SIGNING THIS FORM

All information contained in this application is true to the best of my knowledge and belief. I understand that misrepresentation or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am selected/hired.

I authorize this company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to my employment or me.

Regardless of whether or not I become selected/hired by this company, I recognize that this application is not and should not be considered a contract of employment for any definite period of time. If employed, I understand that I have been hired "at-will" of the employer and my employment may be terminated at any time, with or without cause and with or without notice.

TO BE READ AND SIGNED BY APPLICANT

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

To enter your electronic signature, please draw it using the cursor/pointer of your mouse

Signature:

Date:

This company is an Equal Employment Opportunity employer. We adhere to a policy of making employment decisions without regards to race, color, religion, sex, age, disability or any other protected categories. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

Employment Application