EMPLOYMENT APPLICATION

Application Date:

Position you are applying for:

Type of employment desired:

MobileLandline

Date you are available to Start

Date of Birth

Desired Hourly Wage Range:

Have you worked for GreenRun before:

If yes, when:

Are you an American Citizen?

If no, are you able to legally work in the United States?

Answering “yes” to the below question does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation, and position applied for will be considered.

Have you ever pled “guilty,” “no contest,” or been convicted of a crime?

If yes, give dates and some details:

PREVIOUS EMPLOYMENT HISTORY (begin with most recent position):
Employer One

Employed from

Employed to

Employer Two

Employed from

Employed to

Since this position includes exterior construction work it can be subject to the weather. The summer can be extremely hot and the winter can be cold and wet.

Do you have any pre-existing conditions that would make exterior work in hot, cold or damp weather a challenge for you?

Will you work when it is damp or rainy as long working conditions are deemed to be safe?

Do you understand that there will be days that weather conditions make it unsafe to work and that we do not pay employees for days off due to weather?

This position requires heavy lifting, ladder and scaffold work, use of power tools, use of hand tools, lifting or holding items at or above shoulder height, active use of both hands and the ability to bend, squat and/or kneel at the knees.

Do you have any pre-existing conditions, such as but not limited to surgeries, pain and/or injuries, that might hinder:

Your ability to safely lift heavy items using both hands?

Your ability to safely climb a ladder or scaffolding using both hands?

Your ability to work safely on a ladder or scaffolding using both hands?

Your ability to work safely with hand tools using both hands?

Your ability to work safely with power tools using both hands?

Your ability to hold or lift items at shoulder height or above using both hands?

Your ability to safely bend, squat and/or kneel at the knee?

This position may require the use of a dust mask or respirator due to lumber dust, sheetrock dust, occasional concrete dust as well as simple outdoor debris and dust that is stirred up while you clean or move about an area.

Do you have any pre-existing conditions, such as asthma or other lung issues that might make it unsafe for you to work in dust situations as described above?

Do you ever experience claustrophobia that may make it hard for you to wear a dust mask or respirator?

If a respirator fit test requires you to trim or shave off facial hair to use a respirator or dust mask, are you willing to trim or shave off your facial hair?

If you are offered employment it will be contingent upon one or more of the following:

Showing us your US Driver’s License and your Social Security Card
Passing a Background Check, Passing a Drug Test, and possibly Passing a Physical (all at employer cost)
Providing us with a copy of your current DMV driving record
Providing us with a copy of your current DMV vehicle registration
Providing us with a copy of your current auto insurance showing you as insured and listing your vehicle(s)
Having reliable transportation to and from work
Being reachable by phone as things change constantly in construction

IF offered employment, will you comply with the above listed items?

You understand that, as a small business, we do not offer any benefits besides the state required sick leave.

IMPORTANT: My signature below certifies 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 an employment decision.

My signature below releases employers, schools, or individuals from all liability when responding to inquiries in connection with my application.

My signature below certifies that, in the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

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