Specialty Rigging Co.Online Application Employment ApplicationStep 1 of 520%Applicant InformationName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Date Available*Social Security*Desired Salary*Are you a citizen of the United States?* Yes NoIf no, are you authorized to work in the U.S.? Yes NoAre you currently employed?* Yes NoIf so, may we contact your current employer? Yes NoHave you ever worked for this company?* Yes NoIf so, when?Have you ever been convicted of a felony? Yes NoIf yes, explainPrevious EmploymentCompany NameCompany AddressCompany SupervisorCompany PhoneJob TitleStarting SalaryEnding SalaryResponsibilitiesFromToReason for LeavingCompany NameCompany AddressCompany SupervisorCompany PhoneJob TitleStarting SalaryEnding SalaryResponsibilitiesFromToReason for LeavingCompany NameCompany AddressCompany SupervisorCompany PhoneJob TitleStarting SalaryEnding SalaryResponsibilitiesFromToReason for LeavingHigh School EducationHigh School NameHigh School AddressFromToDid You Graduate? Yes NoDegreeCollege EducationCollege NameCollege AddressFromToDid You Graduate? Yes NoDegreeOther EducationSchool NameSchool AddressFromToDid You Graduate? Yes NoDegreeReferencesPlease list three professional references.Full NameRelationshipCompanyPhoneAddressFull NameRelationshipCompanyPhoneAddressFull NameRelationshipCompanyPhoneAddressGeneral QuestionsAre you capable of lifting 100lbs?* Yes NoCan you work overtime as required?* Yes NoDo you currently or have you ever had a neck injury?* Yes NoIf so, explain:Do you currently or have you ever had a back injury?* Yes NoIf so, explain:Do you currently or have you ever had a shoulder injury?* Yes NoIf so, explain:Special Skills (ex: CDL Drivers License, Welding, etc.)List all here.Disclaimer and SignatureI certify that my answers are true and complete to the best of my knowledge.If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.Signature*Date*Δ
