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Applicant Data:

Application Date

Position Applied For:

Full Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Cell Phone

Email(Required)

Available Start Date

Minimum Salary You Will Accept

If you are under 18 and we require a work permit, can you furnish one?(Required)

Please Explain:

Have you ever worked for this company?(Required)

When & what position?

Are you a citizen of the United States?(Required)

Are you legally allowed to work in the U.S.?

Type of employment desired:

Full Time

Part Time

Temporary

Seasonal

Who referred you to us?

Are they a current employee?

Where did you hear about this position or the company?(Required)

Do you have a current valid driver’s license?(Required)

Are you available for extended travel?(Required)

Education:

High School

High School Address

Street Address Address Line 2 City State ZIP Code

Number of years completed:

Did you graduate?

College/University

College/University Address

Street Address Address Line 2 City State ZIP Code

Number of years completed:

Did you graduate?

Major

GPA

Previous Employment:

(list 3 most recent positions)

Employment Start Date

Employment End Date

Position(s) Held:

Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Title

Responsibilities

Starting Title

Starting Salary

Ending Title

Ending Salary

Reason for leaving:

May we contact this employer for a reference:

Employment End Date

Employment Start Date

Position(s) Held:

Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Title

Responsibilities

Starting Title

Starting Salary

Ending Title

Ending Salary

Reason for leaving:

May we contact this employer for a reference:

Employment End Date

Employment Start Date

Position(s) Held:

Company

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Title

Responsibilities

Starting Title

Starting Salary

Ending Title

Ending Salary

Reason for leaving:

May we contact this employer for a reference:

Professional References:

Name

First Last

Company

Phone

Address

City State

Name

First Last

Company

Phone

Address

City State

Heavy Construction Positions:

Heavy Construction Positions worked:

Superintendent years of experience:

Foreman (Team Leader) years of experience:

Project Manager years of experience:

Project Coordinator years of experience:

Estimator years of experience:

Tunneling years of experience:

CDL Truck Driver years of experience:

Excavator Operator years of experience:

Crawler Dozer Operator years of experience:

Mini Rig Operator years of experience:

Midi Rig Operator years of experience:

Maxi Rig Operator years of experience:

Tractor Backhoe Operator years of experience:

Auger Boring Machine years of experience:

Trencher Operator years of experience:

Hydraulic Crane Operator years of experience:

Floor hand/Laborer years of experience:

Other (please explain):

Other years of experience:

Equipment Experience:

List make and model of equipment you have experience operating or driving:

List any licenses you have:

Pipe Experience:

Check the type and list the diameter(s) of pipe experience you have

Steel

PVC

HDPE

DIP

Steel Pipe Diameter(s)

PVC Pipe Diameter(s)

HDPE Pipe Diameter(s)

DIP Pipe Diameter(s)

Have you worked with trench shields/boxes?

List Depths:

Can you read plans & specs accurately?

Explain Previous Experience:

Shop, Driver & Mechanic Positions:

Shop, Driver & Mechanic previous experience:

Truck Mechanic years of experience:

Heavy Equipment Mechanic years of experience:

Brakes years of experience:

Diagnostic Equipment years of experience:

Hydraulics years of experience:

Electrical Systems years of experience:

Transmissions years of experience:

Small Engines years of experience:

Truck Driver years of experience:

Lowboy Driver years of experience:

Welder years of experience:

Other (please explain):

Other years of experience:

List types of Trucks / Heavy Equipment you have repaired:

List types of Trucks /Heavy Equipment you have operated:

List types of testing tools & equipment you have used:

List certifications obtained:

Professional & Office Positions:

Professional & Office previous experience:

Management years of experience:

Supervising Others years of experience:

Strategic Planning years of experience:

Project Management years of experience:

Office Machines years of experience:

Customer Service years of experience:

Purchasing years of experience:

Accounting years of experience:

Multi-line Phone Systems years of experience:

Administrative Skills years of experience:

IT years of experience:

Other (please explain):

Other years of experience:

List Microsoft Office software you have used:

List database systems you have used:

List major projects or achievements you have completed:

List key technical skills:

Additional Information

Please list any special skills, licenses or other qualifications:

Authorization

I authorize you to make such investigations and inquiries of my employment, criminal, and credit history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or persons from all liability when responding to inquiries in connection with my application. Moreover, I hereby release Atlas Trenchless, LLC. and any agent acting on its behalf from any and all liability of whatsoever nature by reason of requesting such information from any person. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge. I further understand that this application is not intended to be a contract of employment, nor does this application obligate Atlas Trenchless, LLC. in any way if the Company decides to employ me. I understand and agree that my employment is at will and can be terminated by either party with or without notice at any time, for any reason or no reason.

I declare that all information on this application and on my resume is true and complete and hereby acknowledge that I have read and understand the information above.

Signature of Applicant

Signature Date

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Submit Your Application:

Applicant Data:

Education:

Previous Employment:

Professional References:

Heavy Construction Positions:

Equipment Experience:

Pipe Experience:

Shop, Driver & Mechanic Positions:

Professional & Office Positions:

Additional Information

Authorization