Employment Application

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Home/Other Phone
Email*
Date Available to Start*
Date Format: MM slash DD slash YYYY
Salary Requirements*
If you are under 18 years of age, can you provide a work permit?*
- Yes
- No
Please explain*
Have you ever worked for Prime Construction?*
- Yes
- No
When did you work for Prime Construction?*
Are you a citizen of the United States?*
- Yes
- No
Are you legally allowed to work in the United States?*
- Yes
- No
Type of employment desired:*
- Full Time
- Part Time
- Temporary
- Seasonal
Have you ever pleaded guilty, no contest or been convicted of a crime?*
- Yes
- No
Please provide dates and details*
Please summarize your Special Skills or Qualifications*

Electronic Signature
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for employment decision. I hereby release employers, schools or individual from all liability when responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.
Agreement*
- I agree
- I do not agree
Electronic Signature*
By checking the "I agree" box above and typing your name here, you are agreeing to your statements made in this electronic employment application.

Employment History