Apply for a job - Lang Construction Group

First Name

Last Name

Home Phone Number

Cell Phone Number

Do you have a valid driver's license?

Yes
No

Driver's license number

State

Position you are applying for:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Have you worked for us before?

Yes
No

Which projects?

Approximate time period?

Are you legally eligible for employment in this country?

Yes
No

(Proof of U.S. Citizenship or immigration status will be required upon employment)

Have you ever been convicted of a felony?

Yes
No

(Such conviction may be relevant if job-related, but does not bar you from employment)

Last Two Employers

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Phone

Last day worked

Reason for separation:

Employer Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Phone

Last day worked

Reason for separation:

Do you have additional references?

Yes
No

Reference 1 Name

Reference 1 Phone

Reference 2 Name

Reference 2 Phone

Reference 3 Name

Reference 3 Phone

CERTIFICATION AND RELEASE:

I certify that I have read and understand this application along with the job description for which I am applying and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information including, but not limited to, motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.