Employment Form

         We are an equal opportunity employer, and we do not discriminate on the basis of race religion, national origin, sex, age, handicap, marital status, or status as a disabled veteran. Information provided on this application will not be used for any discriminatory purpose.

         Please fill out information on at least three previous employers. Your complete application form will be maintained in our active files for (6) months from the date of application. You may submit a new application at any time.

    Starred Items (*) are required

    First Name

    Last Name

    Your Email

    Phone Number

    Street Address


    City


    State


    Zip


    How were you referred to Dyer Construction, Inc?

    Do you have a valid Georgia Drivers License?

    yesno

    If 'YES' list all traffic violations in the past three years.


    Last or Present Job

    Name of Last or Present Company


    Type of Business


    Type or Classification of Job


    Description of Work Duties


    Business Phone Number


    Business Address


    City


    State


    Zip


    Supervisor's Name


    Supervisor's Phone Number


    Base Salary (hr)


    Date Started


    Date Ended


    Reason for Leaving

    Job #2

    Name of Company


    Type of Business


    Type or Classification of Job


    Description of Work Duties


    Business Phone Number


    Business Address


    City


    State


    Zip


    Supervisor's Name


    Supervisor's Phone Number


    Base Salary (hr)


    Date Started


    Date Ended


    Reason for Leaving

    Job #3

    Name of Company


    Type of Business


    Type or Classification of Job


    Description of Work Duties


    Business Phone Number


    Business Address


    City


    State


    Zip


    Supervisor's Name


    Supervisor's Phone Number


    Base Salary (hr)


    Date Started


    Date Ended


    Reason for Leaving

    Job #4

    Name of Company


    Type of Business


    Type or Classification of Job


    Description of Work Duties


    Business Phone Number


    Business Address


    City


    State


    Zip


    Supervisor's Name


    Supervisor's Phone Number


    Base Salary (hr)


    Date Started


    Date Ended


    Reason for Leaving

    High School

    Name of High School


    High School Address


    City


    State


    Zip


    Date Started


    Date Ended


    Did You Graduate?

    yesno

    Technical/Trade

    Name of Trade School


    Type of Degree


    Trade School Address


    City


    State


    Zip


    Date Started


    Date Ended


    Did You Graduate?

    yesno

    College

    Name of College


    Type of Degree


    College Address


    City


    State


    Zip


    Date Started


    Date Ended


    Did You Graduate?

    yesno

    Other Training

    Name of Institution


    Type of Degree


    Institution Address


    City


    State


    Zip


    Date Started


    Date Ended


    Did You Graduate?

    yesno

    Construction Skills

    Types of Machines Operated/Years


    Construction Skills


    Years of Experience


    Served Apprenticeship

    yesno

    Type of Apprenticeship


    Office Skills

    Typing (Words per Minute)


    Computer Skills (Hardware/Software)


    Other Skills


    Military Record

    Branch of Service


    Start Date


    End Date


    Present Military Affiliation


    Kinds of training and duty while in service


    Reference #1

    First Name

    Last Name

    Title/Releationship

    Phone Number

    Street Address


    City


    State


    Zip


    Occupation


    Reference #2

    First Name

    Last Name

    Title/Releationship

    Phone Number

    Street Address


    City


    State


    Zip


    Occupation


    Submit Resume


    May we contact your present employer?

    yesno

    Wage or salary required


    Date Available


         I hereby certify that the answers and other information are true and correct and that I understand any misrepresentation or omission of facts on my part will be justification for separation from the company's service, if employed. I understand that my employment may be contingent upon receipt of an alien registration number, verification of birth, and any other pertinent information bearing upon my employment, and that my continued employment depends upon the will of the company or myself.

    Current Date


    Full Online Signature