APPLICANT INFORMATION
Soderberg Construction Employment Application

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

LICENSES-SKILLS-QUALIFICATIONS:

DRIVING QUALIFICTIONS & EXPERIENCE

LICENSES HELD:

EQUIPMENT EXPERIENCE


Tractor, Semi & Trailer
Tractor W/ Two Trailers:
Straight Truck:
Other:

ACCIDENTS & VIOLATIONS:

Accidents in the past three years (List most recent first):

DISCLAIMER AND SIGNATURE

I certify that all the information submitted by me on this application is true and complete. I understand that employment is conditioned upon a background check and if any false information, omissions, or misrepresentations are discovered, my application will be rejected If I am employed, my employment will be "At Will" and may be terminated at any time with or without cause and with or without notice. I also understand the terms and conditions of my employment may change at any time. If employed I agree to conform to all Soderberg's rules and regulations. I also agree to submit to any medical examination and drug test as teemed appropriate by the company. I understand that the filling out of this application or the advent of an interview does not imply a promise for employment and does not obligate Soderberg's to hire. Only the President of the company can or will enter into an employment agreement. Applicants for position that require driving a commercial motor vehicle (CMV) at any time will be required to undergo controlled substances and at our discretion, alcohol testing prior to employment and will be subject to further testing throughout the period of employment. Applicants will also be asked to sign forms for release of information from previous employers where driving a CMV was one of your functions. Failure to sign will prevent this employer from using you as a CMV driver.

This form has been designed to strictly comply with State and Federal fair employment practice laws prohibiting employment discrimination. We are an equal opportunity employer.