Western Underground, Inc. Quality installation of underground utilities

Employment Application

If you would like to apply for a position with Western Underground, Inc., fill out the following Employment Application and click submit at the bottom of the page.

First Name
Last Name
Address
City
State
Zip Code
Telephone Number
Email Address
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.A.?
ARE YOU ABLE TO PROVIDE A VALID ARIZONA DRIVERS LICENSE?
Position Desired
Salary Desired
Date you can start
Are You Currently Employed?
If so may we inquire of your present Employer?
Have you ever applied to this Company before?
If so when?
EDUCATION
Name of High School Attended
Years Completed
Graduate or Degree
Name of Trade/College/University Attended
Years Completed
Field of Study
Graduate or Degree

MILITARY SERVICE
Duty/ Specialized Training

The position being applied for is physically demanding. It may require heavy lifting physical stamina and working in adverse weather conditions including EXTREME heat.
Can you perform the basic functions with or without A.C. accommodation?
Are you able to obtain an AZ Dep't of Public Safety Level One Fingerprint Clearance Card? (required for work on schools)
Have you ever pleaded guilty or "no contest" to a crime or been convicted of a crime?
If yes explain number of conviction(s) nature of offense(s) leading to conviction(s) how recently such offense(s) was/were committed sentence(s) imposed and type(s) of rehabilitation:
*NOTE: Answering "yes" to this question is not an automatic bar to employment. Only those crimes that are substantially related to the position you are seeking will be considered - so be truthful and complete.

REFERENCES: List two personal references who are not relatives or former supervisors.
Name
Address
Telephone
Occupation
Years Known

Name
Address
Telephone
Occupation
Years Known

EMPLOYMENT HISTORY: List last employment first include summer or temporary jobs. Be sure all your experience or Employers related to this job are listed in the position summary.
Employer Name
Employer Address
Position Title/Duties Skills
Supervisor's Name
Telephone Number
Dates Employed From
To
Reason For Leaving

Employer Name
Employer Address
Position Title/Duties Skills
Supervisor's Name
Telephone Number
Dates Employed From
To
Reason For Leaving

Employer Name
Employer Address
Position Title/Duties Skills
Supervisor's Name
Telephone Number
Dates Employed From
To
Reason For Leaving

Types of mechanical equipment you are qualified to operate or repair

Special Certifications

Additional skills including supervision skills other languages or information regarding the career/occupation you wish to bring to the employer's attention

In case of accident or illness please contact Name
Telephone Number
Relationship

Information to the applicant: As part of our procedures for processing your employment application your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application and are subsequently hired you may be discharged from your job. You may make a written request for information derived from the checking of your references.
If necessary for employment you may be required to: supply your birth certificate or other proof of authorization to work in the US have a criminal background check and drug test and/or sign a conflict of interest agreement and abide by its terms
I understand and agree to the information shown above:

By inserting my name below I am agreeing to an electronic signature
NAME ( FIRST LAST)
DATE
Equal Employment Opportunity: While many employers are required by Federal Law to have an Affirmative Action Program all employers are required to provide an Equal Employment Opportunity and may ask your national origin race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no effect on your application for employment.
Do not enter anything in this field: