Your Superior Career - Superior Waterproofing

I understand that Superior is a "Drug Free" workplace. If I am offered a job I consent to a drug test and being placed in the CDS Random Drug Test Program.*

Yes
No

Name*

Address*

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

Phone*

Email*

18 yrs or older?*

Yes
No

Referred By

Desired Position

Can you meet the physical demands of this job? (Lift 50-100 lbs, bend, squat, twist and stand 8 hrs day, wear a respirator, extreme Hot & Cold Climate)

Yes
No

Do heights bother you? (30 stories on scaffold or lift)

Yes
No

Are you able to travel out of town occasionally?

Yes
No

Do you have transportation?

Yes
No

Do you have a valid driver's license?

Yes
No

Do you have a mobile phone?

Yes
No

Please list any construction or safety training (such as Lifts, OSHA 10-hour, CPR, Fall Protection)

Date Can Start

If currently in a Union, which one?

Current Employer

Start Date

Contact Person

Current Employer's Address

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

Current Employer's Phone #

Job Description

Why are you leaving?

Previous Employer

Start Date

Date Left

Contact Person

Previous Employer's Address

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

Previous Employer's Phone

Job Description

Why did you leave?

What High School did you attend?

How many years did you attend High School?

Did you graduate High School?

Yes
No

What College did you attend?

How many years did you attend College?

Subjects studied in College?

Did you graduate College?

Yes
No

What Trade/Business school did you attend?

How many years did you attend Trade/Business school?

Subjects studied at Trade/Business school?

Did you graduate Trade/Business school?

Yes
No

Special Training or Skills

Hobbies

Are you a Veteran

Yes
No

Military Branch

Date you Joined

Date you Completed Service

Jobs Performed

Have you been convicted of a felony within the last 5 years?

Yes
No

If Yes, please explain

Application