Application For Employment

Please complete the following application and submit below. You may send any additional application documents via email to

Application Information
Name *
Select One
Desired type of work
Select all that apply:
Contact Information
Phone *
Home Address *
Home Address
Have you been employed here before? *
Do you have your own transportation?
Do you have a valid Driver's License? *
Driver's License Information
License Expiration Date
License Expiration Date
Employment History
Please provide accurate, complete information for your most recent full-time or part-time employment history
1. Current Employer
2. Previous Employer
Reference I
Reference I
Phone Number
Phone Number
Reference II
Reference II
Phone Number
Phone Number
Before signing this application, you should ask for assistance if you do not understand any statement, request for information or need help in completing this application. USE OF ILLEGAL DRUGS It is the desire our Company. to provide a drug-free workplace for the safety of its employees and the general public. Involvement with illegal drugs by our employees is contrary to this objective. • The illegal use, sale, distribution, or possession of any narcotic, drug or controlled substance, either on or off the job, will result in the immediate termination of employment. • Every applicant who is considered for employment will be tested for the use of illegal drugs. • Every employee remains subject, as a condition of continued employment, to additional drug testing, at various times to be selected by the Company. • Failure to pass a drug screen test will preclude initial or continued employment with the Company. AUTHORIZATION AND RELEASE FOR DRUG SCREEN TESTS I hereby authorize Blount Construction Co., Inc... (along with any Physician, Clinic, Hospital or Laboratory designated by the Company to perform tests on me for the detection of illegal drugs. I give my permission to the designated Physician, Clinic, Hospital or Laboratory to release the results of such tests to the Company. I agree to release, forever discharge and hold harmless Blount Construction Co., Inc, including its successors, assigns, officers, directors, agents and employees from any and all actions, cause of action, claims and demands, for any damage or loss which may be sustained by me, as a result of any employment action or separation from employment which may take place due to my failure to pass a drug screen test, or my failure to otherwise comply with the company’s anti-drug policy. OTHER CONDITIONS OF EMPLOYMENT I understand that the Company may contact all persons, schools, and employers, current or former, to verify my employment or obtain information that may be required to arrive at an employment decision. I hereby release the Company and the aforementioned who provide such information from any liability and damages regarding the provision of such information. I acknowledge that my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I understand that no representative of the Company, other than a Vice-President of the Company, has any authority to enter into any agreement for employment for any specified period of time or to make any agreement that contradicts or modifies the foregoing in any manner. Any written or oral statements to the contrary are hereby expressly disavowed and should not be relied upon by current or prospective employees. I certify by my signature below that if employed by the Company, I will be available for out of town work at all times and for the duration of time necessitated by project conditions. I hereby declare the information provided by me in this application for employment as true, correct and complete to the best of my knowledge. I understand that if employed, any misstatement or omission of fact on this application may result in discharge.
Prospective Employee Self-Disclosure Survey
This form is to be filled out by each prospective employee. Providing information is VOLUNTARY and is not required for employment. This form is for statistical purposes only and will not be used in determining employment eligibility. This information will be maintained separately from your application and will only be accessible by the Human Resources Department of Blount Construction Company,Inc.
Ethnic Group/Race
Blount Construction Company, Inc. is an Equal Employment Opportunity Employer. We encourage all minorities and females to apply.