Apply Online – Brown Excavating Company, Inc.

First & Last Name *

Phone Number

Email Address *

Current Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Employment Desired

Date you can start

Do you have a current, valid Driver license?YesNo

Are you currently employed?YesNo

If so, can we inquire of your present employer?YesNo

Have you ever applied to this company before?YesNo

Have you had a physical exam in the last 5 years?YesNo

Do you consent to a background check during the hiring process?YesNo

Can you pass a physical and drug test to be hired?YesNo

Do you have a reliable source of transportation to get you to and from work everyday?YesNo

Have you ever been convicted of a crime? If so, please explain. Please note that a conviction may not disqualify you, but a false statement will.

Do you have any physical deformities or disabilities? If yes, please explain.

Have you ever been paid Workman's Compensation for an injury? If yes, describe all injuries you have been paid for.

Work Experience Record. Please list all information for four latest employers. List most current employer first. 1. Name of Employer 2. Address 3. Phone number 4. Employed Dates 5. Job title 6. Equipment operated 7. Reason for leaving

To be completed by vehicle driver applicants. What type of DL do you have? Any restrictions? If yes, please explain. License Number? State? Expiration Date? Number of moving Violations?

Please list below the types of machines you can operate. Please list by each machine your length of time in experience on the machines. Please advise if you are a finish operator by which machies.

Emergency Contact Information. Person to notify, relationship & phone number

Attach Resume

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CertificationI AgreeI certify that the information in this application is true and understand that misrepresentation or false or omitted facts may result in my termination, regardless of the time of discovery by the company. I also understand that, if hired, my employment is for no definite period and may be terminated at anytime without written notice and that, absent a written a contract signed by the President of the company, I will remain an at-will employee and can be terminated at any time without any notice. I authorize investigation of the statements contained herein and the references listed above to give you and and all information concerning my previous employment and any pertinent information such references may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.