Employment Opportunities with a Kentucky Licensed Surveying and Engineering Office / Four Rivers Land Surveying and Engineering, Eddyville, KY

● Four Rivers Engineering & Surveying Employment Opportunity Application ●

GO BACK TO EMPLOYMENT OPPORTUNITY PAGE

POSITION BEING APPLIED FOR: DATE:

NAME:

ADDRESS:

CITY:

STATE:

ZIP:

PHONE (HOME):

PHONE (OFFICE):

E-MAIL:

● How Did Your Hear About Us? ●

	ADVERTISEMENT
	EMPLOYEE
	GOVERNMENT EMPLOYMENT AGENCY
	PRIVATE EMPLOYMENT AGENCY
	WALK-IN
	RELATIVE
	OTHER

● May We Contact You? ●

YES

IF YES:

	HOME	BEST TIME
	OFFICE	BEST TIME
	AT WORK	BEST TIME

● If No, Please Give a Brief Explanation ●

● If You Are Under Age 18 and it is Required, Can You Provide a Work Permit? ●

YES

● Are You Legally Eligible for Employment in the Country? ●

YES

● Type of Employment Desired? ●

FULL TIME

PART TIME

TEMPORARY

SEASONAL

EDUCATIONAL CO-0P

DATE AVAILABLE FOR WORK:

WHAT IS YOUR DESIRED SALARY RANGE?

$ to $

WILL YOU RELOCATE IF THE JOB REQUIRES IT?

YES

WILL YOU RELOCATE IF THE JOB REQUIRES IT?

YES

WILL YOU WORK OVERTIME IF REQUIRED

YES

HAVE YOU EVER BEEN BONDED

YES

HAVE YOU EVER PLED "GUILTY" OR "NO CONTEST" TO, OR BEEN CONVICTED OF A CRIME?

YES

● Employment History ●

Provide the following information on your past and current employers, starting with the most recent.

E-mail any additional information to jcselph@fourriverssurveying.com.

(BE SURE TO INCLUDE YOUR NAME AND "EMPLOYMENT APPLICATION" IN THE SUBJECT LINE).

Explain any gaps in employment in the "Comments" section blow.

PLEASE TO NOT WRITE "SEE RESUME".

EMPLOYER:     TEL#:

ADDRESS:

STARTING JOB TITLE:

FINAL JOB TITLE:

IMMEDIATE SUPERVISOR AND TITLE:

REASON FOR LEAVING:

MAY WE CONTACT THIS EMPLOYER FOR REFERENCE? YesNoLater

DATES OF EMPLOYMENT: FROM TO

HOURLY RATE/SALARY STARTING:   $ PER/

HOURLY RATE/SALARY ENDING:     $ PER/

SUMMARIZE THE TYPE OF WORK PERFORMED AND JOB RESPONSIBILITIES (PLEASE LIMIT TO 400 CHARACTERS)

● Comments Including Any Gaps in Employment ●

PLEASE LIMIT TO 200 CHARACTERS

● Skills and Qualifications ●

PLEASE LIMIT TO 200 CHARACTERS

SUMMARIZE ANY SPECIAL TRAINING, SKILLS, LICENSES AND / OR CERTIFICATES THAT MAY QUALIFY YOU FOR THE POSITION TO WHICH YOU ARE APPLYING.

● Educational Background ●

A. List last three (3) schools attended, starting with the most recent

B. List number of years completed

C. Indicate degree or diploma earned, if any

D. Grade Point Average or Class Rank

E. Major field of study

F. Minor field of study (if applicable)

A. School	B. Years Completed	C. Degree Diploma	D. GPA Class Rank	E. Major	F. Minor

● References ●

List name and telephone number of three business / work references that are NOT related to you and are NOT previous supervisors.

If not applicable, list three school or personal references who are not related to you.

Name	Telephone	# OF YEARS KNOWN

● Additional Information ●

List professional, trade, business or civic associations and any offices held.

EXCLUDE MEMBERSHIP THAT WOULD REVEAL RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP. AGE, MENTAL

OR PHYSICAL DISABILITIES, VETERAN / RESERVE, NATIONAL GUARD OR ANY OTHER SIMILARLY PROTECTED STATUS.

Organization	Office Held

● List Any Special Accomplishments, Publication, Awards, etc ●

EXCLUDE MEMBERSHIP THAT WOULD REVEAL RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP. AGE, MENTAL

OR PHYSICAL DISABILITIES, VETERAN / RESERVE, NATIONAL GUARD OR ANY OTHER SIMILARLY PROTECTED STATUS.

PLEASE LIMIT TO 200 CHARACTERS

● List Any Additional Information You Would Like Us to Consider●

EXCLUDE MEMBERSHIP THAT WOULD REVEAL RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP. AGE, MENTAL

OR PHYSICAL DISABILITIES, VETERAN / RESERVE, NATIONAL GUARD OR ANY OTHER SIMILARLY PROTECTED STATUS.

PLEASE LIMIT TO 200 CHARACTERS

►Please review the above information for accuracy before continuing to read this application statement◄

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents, to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims that I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organization for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and to complete a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard. I also understand that in order to maintain a safe, drug-free environment for all of our employees, all prospective employees will be tested for controlled substances prior to consideration for hire. I have no objection to and agree to be tested for controlled substances.

FOUR RIVERS LAND SURVEYING MAINTAINS A DRUG-FREE AND SMOKE-FREE WORKPLACE.

FOUR RIVERS LAND SURVEYING PERFORMS BACKGROUND CHECKS ON ALL EMPLOYEES INCLUDING DRIVING RECORDS.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept the terms of the foregoing Applicant Statement.

Signed:

(By typing your name above, you agree to the terms of the Applicant Statement.)

If you have read and signed the above Application Statement and have verified the information you have included with this application,

Please click on the submit button and you will see a verification that we have received your application.