Office
(210) 651-6451

APPLICATION FOR EMPLOYMENT
Fax
(210) 651-6214
(PRE-EMPLOYMENT QUESTIONNAIRE)
   (AN EQUAL OPPORTUNITY EMPLOYER)
PERSONAL INFORMATION
NAME: SOCIAL SECURITY NUMBER:
MARITAL STATUS: MARRIED SINGLE DATE OF BIRTH:
HAVE A COMMERCIAL DRIVER’S LICENSE? OPERATOR DRIVER’S LICENSE?
NUMBER: STATE: NUMBER: STATE:
OWN A VEHICLE? IF NOT, DO YOU HAVE TRANSPORTATION TO AND FROM WORK?
DO YOU HAVE ANY FORM OF INJURY OR ILLNESS WHICH WOULD PREVENT YOU FROM PERFORMING DUTIES WITHIN THE SCOPE OF YOUR EMPLOYMENT? . IF SO, PLEASE GIVE A BRIEF DESCRIPTION OF THE INJURY OR ILLNESS:
PRESENT ADDRESS:
STREET
  CITY   STATE
ZIP
  
PERMANENT ADDRESS:
STREET
  CITY   STATE
ZIP
  
HOME PHONE NUMBER: MOBILE PHONE NUMBER:
EMERGENCY PHONE NUMBER: EMERGENCY CONTACT NAME:
ALT. EMERGENCY CONTACT #: NAME:
ARE YOU EITHER A U.S. CITIZEN OR AN ALIEN AUTHORIZED TO WORK IN THE U.S.?
EMPLOYMENT DESIRED
POSITION: DATE YOU CAN START:
SALARY DESIRED: ARE YOU EMPLOYED NOW?:
HAVE YOU EVER APPLIED TO THIS COMPANY BEFORE? WHEN?  
REFERRED BY:  
GENERAL INFORMATION
SPECIAL SKILLS:
DO YOU OWN YOUR OWN IRON WORKING TOOLS? IF SO, LIST:
DO YOU OWN A SAFETY HARNESS?
LIST ANY LICENSES:
LIST ANY TRAINING:
LIST ANY TRAINING IN OSHA SAFETY PROCEDURES:
LIST ANY CERTIFICATION(S):
  Master/Journeyman Rigger: Yes/No:    
Crane Operator: Yes/No:
Electrical: Yes/No:
Winch Operator: Yes/No:
Free Climbing: Yes/No:
Antenna Coax Installation: Yes/No:
Sweep Testing: Yes/No:
Theodolite or transit level operation: Yes/No:
CPR: Yes/No:
Other:
WOULD YOU BE WILLING TO PAY FOR TRAINING IN ANY OF THE ABOVE AREAS TO BE CERTIFIED?
DO YOU HAVE EXPERIENCE IN ANY OF THE FOLLOWING AREAS:
  Rigging: Yes/No:    
Hoisting: Yes/No:
Gin Pole Erection Yes/No:
  To What Height?  
  Guyed Tower: Yes/No:
  Self-Support Tower : Yes/No:
Microwave Installation: Yes/No:
Antenna Installation: Yes/No:
Cadwelds or gounding systems: Yes/No:
Come-a-long operation: Yes/No:
Backhoe: Yes/No:
Trencher: Yes/No:
Dynamometers or tensionmeters: Yes/No:
Fork Lift Operator: Yes/No:
Other:
EDUCATION
DO YOU HAVE A HIGH SCHOOL DIPLOMA? Yes/No: Dated:  
NAME OF HIGH SCHOOL: CITY: STATE:  
DO YOU HAVE a G.E.D.? Yes/No: Dated:
DO YOU HAVE A CERTIFICATE OF COMPLETION FROM A TECHNICAL OR TRADE SCHOOL?
Yes/No: Dated:
NAME OF TRADE SCHOOL: CITY: STATE:
FORMER EMPLOYERS
(List below Last Four Employers, starting with the last one first)

DATES
Month/Year


Name, Address & Telephone Number of Employer


Salary


Position

Reason For Leaving
From:
To:  
Name of Supervisor/Foreman:
From:
To:  
Name of Supervisor/Foreman:
From:
To:  
Name of Supervisor/Foreman:
From:
To:  
Name of Supervisor/Foreman:
 
PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING:
“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, AND RELEASE ALL PARTIES FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING SAME TO YOU.

I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE AND WITHOUT CAUSE.”
 
DATED:
_______________________________   		SIGNATURE:
______________________________________________
  PRINTED NAME:
______________________________________________