First Name: *

Middle Name: *

Last Name: *

Address: *

City: *

State: *
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Postal Code: *

Phone: *

Email Address: *

How were you referred to McAlvain Companies, Inc.:*

Applied to McAlvain Before

Have you ever applied for employment with us: *

---YesNo

Social Security Number:

Desired Position: *

Expected Pay: *

Full Time

Apart from absence for religious observance, are you available for full-time work: *

---YesNo

If you are not, specify when you are available:

Will you work overtime if asked: *
---YesNo

Are you legally eligible for employment in the United States: *
---YesNo

When will you be available to begin work: *

MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDay12345678910111213141516171819202122232425262728293031Year201820192020

Other special training or skills (languages, machine operations, etc) that are not listed on your resume:

Graduate School

School Name and Location:

Course of Study:

Number of Years Completed:

Did you graduate:
---YesNo

Degree of Diploma:

---

College

School Name and Location:

Course of Study:

Number of Years Completed:

Did you graduate:
---YesNo

Degree of Diploma:

---

Business/Trade/Technical School

School Name and Location:

Course of Study:

Number of Years Completed:

Did you graduate:
---YesNo

Degree of Diploma:

---

High School

School Name and Location:

Course of Study:

Number of Years Completed:

Did you graduate:
---YesNo

Degree of Diploma:

---

Elementary School

School Name and Location:

Course of Study:

Number of Years Completed:

Did you graduate:
---YesNo

Degree of Diploma:

---

Membership in Professional or Civic Organizations (Exclude those that may disclose your race, color, religion or nationality):

Company One

Company Name: *

Telephone: *

Address: *

City: *

State: *
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code: *

Employed From - To

Name of Supervisor: *

Weekly Pay

Job Title: *

Describe your Work: *

Reason for Leaving: *

---

Company Two

Company Name:

Telephone:

Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code:

Employed From - To

Name of Supervisor:

Weekly Pay

Job Title:

Describe your Work:

Reason for Leaving:

---

Company Three

Company Name:

Telephone:

Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code:

Employed From - To

Name of Supervisor:

Weekly Pay

Job Title:

Describe your Work:

Reason for Leaving:

We may contact the employers listed above unless you indicate those you do not want us to contact. If no, please explain:

Did you serve in the U.S. Armed Forces: *
---YesNo

Describe any training received relevant to the position for which you are applying:

Have you ever been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court: *
---YesNo

State names of relatives and friends working for us, other than your spouse:

I understand that as part of my prospective employment with McAlvain, I will be asked to take a drug and/or alcohol test pursuant to the company's DRUG FREE WORKPLACE Policy: *
---YesNo

Are you physically capable, with or without accommodation, of performing strenuous work such as lifting, pulling, pushing and/or carrying frequently 25-50 pounds and occasionally up to 80 pounds?: *
---YesNo

I understand that these tasks requiring this type of conditioning and stamina may be done anywhere from 1 to 20 times per day: *
---YesNo

I understand that as part of my prospective employment with McAlvain, I will be required to pass a pre-placement physical, at no cost to me, for positions requiring strenuous work as listed above: *
---YesNo

The information provided in this Application for Employment is true, correct and complete. If you employ me, any misstatement or omission of fact on this application may result in my dismissal: *
---YesNo

I understand that acceptance of an offer of employment creates no obligation upon you, the employer, to continue to employ me in the future: *
---YesNo

As part of our Affirmative Action obligations, we request you check the applicable box below. This information is strictly voluntary on your part. Thank you:
American Indian (including Eskimo)HispanicAsianCaucasianAfrican American

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