Employment Application Please fill out the form below to apply for employment at Andrews Construction. Thank you! Step 1 of 5 20% We consider applicants for all positions without regard to race, color, religion, creed, sex, gender identity, national origin, age, disability, sexual orientation, marital status, veteran or military status or any other legally protected status. In accordance with the Immigration Reform and Control Act of 1986, both new employees and re-hires will be required to provide original documentation establishing their identity and authorization to work in the United States. The I-9 form will be used for this purpose and must be provided by the employee within three (3) days after employment begins.Basic InformationName First Last Today's Date MM slash DD slash YYYY Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Physical Address(if different from above) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail How did you hear about Andrews Construction Co., Inc.?NewspaperOnlineEmployeeOtherIf other, how did you hear about us? Position Applied For More InformationAre you authorized to work in the United States? Yes No Are you at least 18 years old? Yes No Do you have a valid driver license? Yes No Please provide your license ID number. Do you have a current DOT Medical Card? Yes No Please provide your DOT Medical Card expiration date. Do you have an OSHA-10 card? Yes No Please provide your OSHA-10 date of certification. Do you have a MSHA Certification? Yes No Please provide the date of your MSHA certification. You will be asked for a photocopy of your driver license, DOT medical card, OSHA 10 and MSHA card when appearing for an interview.Have you applied for a job with us before? Yes No Please provide the date you previously applied with us. Have you ever been employed with us before? Yes No Please provide the dates you worked for us. On what date are you available for work? MM slash DD slash YYYY Are you currently employed? Yes No May we contact your present employer? Yes No Are you currently on lay-off subject to recall? Yes No Please provide your employer name. Are you available to work: Full Time Part Time Seasonal Do you have reliable transportation?Due to the nature of our business, employees are expected to travel to assigned job site. Yes No Please explain.Provide more details on your transportation situation. Employment History & QualificationsPlease provide detail for your last three jobs, listing most recent employer first. If you haven't had three jobs, please fill out as many as you can.Please list relevant skills, training, or experience:Please list types of construction equipment that you can operate:Employment HistoryEmployer #1Employer/Company Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Town/City Phone NumberSupervisor's Name Position/Title Pay Rate Duties/ResponsibilitiesEmployer #2Employer/Company Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Town/City Phone NumberSupervisor's Name Position/Title Pay Rate Duties/ResponsibilitiesEmployer #3Employer/Company Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Town/City Phone NumberSupervisor's Name Position/Title Pay Rate Duties/ResponsibilitiesPlease list other relevant jobs or work experience, if any? Education and ReferencesHigh School City, State From: To: Did you graduate from high school? Yes No College City, State From: To: Did you graduate from college? Yes No Degree Trade School City, State From: To: Did you graduate from trade school? Yes No Degree Other City, State From: To: Did you graduate? Yes No Degree ReferencesReference #1Name Town/City Phone Number and/or Email Address Relationship Reference #2Name Town/City Phone Number and/or Email Address Relationship Applicant's Certification and AgreementPlease read carefully. By filling my name in the field below and/or submitting this information electronically, I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that should Andrews Construction offer me a job, I must pass a post-offer physical exam and drug screen before employment begins. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand that completing this application does not indicate that there is a position open and does not obligate Andrews Construction Co, Inc. to hire. Your NameThis constitutes a signature. Today's Date MM slash DD slash YYYY Δ