Benchmark Construction

2422 East High Avenue

New Philadelphia, Ohio 44663

Benchmark Construction is an Equal Opportunity Employer, committed to employing individuals without regard to race, color, age, sex, marital status, veteran status, religion, creed, national origin, ancestry, or handicap.

General Information

Date of Application *

Date you can Start *

Salary Desired *

Name *

Date of Birth *

Current Address *

Previous Address

Cell Phone Number *

Home Phone Number

Are you prevented from becoming a lawfully employed in this country because of Visa or Immigration status? Proof of citizenship of immigration status is required by Federal Law and copies will be on file upon employment. *

Employment History

Have you ever applied to or been employed by Benchmark Construction before? *

If yes, give dates:

Are you employed now? *

If so, may we contact your present employer? *

Person to contact

Phone

If we cannot inquire of your present employer, please explain why

Are you currently on lay off and subject to recall? *

If employed, does your employment require you to continue working, or restrict your activities after leaving your current employment, for any period of time? *

If yes, until what date?

What position(s) are you applying for? *

What qualifications, skills, or trainings do you have for the position(s) that you are applying for? *

Are you physically and mentally capable of performing the essential duties of the position for which you are applying? *

If No, please explain

Are you a veteran of the U.S. Military services? *

If yes, what branch?

Have you ever been convicted of a crime, other than a minor traffic violation, within the last ten years? *

If Yes, please describe.

Employment History Details

List below your last four employers, beginning with your current or most recent employer.

Employer 1

From *

To *

Name/Address/Phone/Contact of Employer *

Wage or Salary & Position Held *

Reason for Leaving *

Education

Enter your education history below

High School

Name and Address *

Years Attended/Dates Attended *

Did you graduate? *

Subjects Studied *

Trade, Business, or Technical School

Name and Address *

Years Attended/Dates Attended *

Did you graduate? *

Subjects Studied *

College or Other Special Study or Research

Name and Address *

Years Attended/Dates Attended *

Did you graduate? *

Subjects Studied *

References

Give the names of four persons, not related to you, whom you have known at least one year

Reference 1

Name *

Address *

Phone *

Occupation and number of years acquainted *

Applicant's Certification and Authorization

Please Read This Statement Carefully

I understand and agree that, if I am employed by Benchmark Construction, my employment is for no definite period of time and can be terminated, with or without cause or notice at any time, at the option of either Haugh Construction, Inc. DBA Benchmark Construction, or myself.

Applicant’s Signature *

Date *

Our Work