Compass Contracting, Inc. - Job Application

Phone:	(757) 827-5760
Fax:	(757) 827-5284
Email:	info@compasscontracting.com
Address:	407 Copeland Drive Hampton, Virginia 23661

Personal Information

Name:

SSN:

Address:

City:

State:

Zip:

Phone:

Email:

Are you 18 years or older?

YES NO

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?

YES NO

Have you ever been convicted of a felony?

YES NO

Do you have any injuries or illnesses that would prevent you from performing your job?

YES NO

Have you ever filed for or received workman's compensation?

YES NO

Do you have a valid driver's license? YES NO

Do you have your own transportation? YES NO

Employment Desired

Position:

When can you start:

Salary Desired:

Are you employed now?

YES NO

May we contact your current employer?

YES NO

Ever applied to this company before?

YES NO

Ever worked for this company before?

YES NO

General

Special Training:

Special Skills:

Former Employers

Employer's Name:

Employer's Address:

Starting Date:

Leaving Date:

Starting Salary:

Final Salary:

Job Title:

May we contact your supervisor?

YES NO

Supervisor Name:

Phone No.:

Work Performed:

Reason for Leaving:

Employer's Name:

Employer's Address:

Starting Date:

Leaving Date:

Starting Salary:

Final Salary:

Job Title:

May we contact your supervisor?

YES NO

Supervisor Name:

Phone No.:

Work Performed:

Reason for Leaving:

References:

List three persons not related to you, whom you have known at least one year.

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Years Acquainted:

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Years Acquainted:

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Years Acquainted:

Authorization:

I certify that all information submitted by me on this application is true and complete and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulation, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and condition of my employment may be changed, with our without cause and with or without notice, at any time by the company.