Employment Application
Collins Contracting Company, Inc. (the “Company”) is an equal opportunity employer.  All qualified applicants will be considered without regard to race, color, creed, religion, ancestry, national origin, age, sex, gender, pregnancy, marital status, disability, veteran status or other protected status.  This application for employment is good for sixty (60) days only.  Consideration for employment after sixty (60) days requires a new application.
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Full Name: *
Address: *
Phone Number: *
Email:
What position are you applying for? If applying for truck driver it is necessary to supply us with a current DMV record.  CDL may be requested for some some driving positions. *
Date you can start? *
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Are you currently employed? *
Are you able to work overtime, when and if necessary? *
Can you perform the essential requirements of this job with or without reasonable accommodation? *
Are you legally eligible to work in the U.S.? *
Have you ever worked for Collins Contracting? *
Have you ever been convicted of a felony? Please exclude information concerning any arrest or criminal charge against you that has been expunged.  You are not required to disclose such information under Virginia law. Further, a conviction record will not necessarily be a bar to employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered. *
Were you referred to Collins Contracting? *
If so, who referred you?
Do you have a valid driver’s license? *
Are you at least 18 years of age or older? *
Did you graduate from high school? *
Did you go to college or trade school? *
If so, where did you go to college or trade school?
Please describe your last two jobs.  Please include employer name and your past job title. *
Please provide one reference and include his or her name and contact information *
Disclaimer
I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give the Company any and all information concerning my previous employment and any pertinent information that they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to the Company. I further understand that a criminal check may be made as part of my employment consideration.

I understand and agree that, if hired, my employment is at-will and is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.
In consideration of my employment, if hired, I agree to conform to the Company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time at either my or the Company's option.

I also understand and agree that the terms and conditions of my employment, if hired, may be changed, with or without cause, and with or without notice, at any time by the Company.

I understand that no Company representative, other than its president, and then only when in writing and signed by its president, has any authority to enter into any agreement for any specific period of time or to make any agreement contrary to the foregoing. I further understand that this employment application is not an offer of employment.

Agree to Disclaimer? *
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