Apply for Asphalt Paving Laborers - Indiana, Pa.

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Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Asphalt Paving Laborers - Indiana, Pa.
ID:	1083
Department:	Paving
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

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Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Application for Employment

PERSONAL INFORMATION

* Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment):

Yes No

* Are you at least 18 years or older? (If no, you may be required to provide authorization to work):

Yes No

* Have you ever worked for this Company before?:

Yes No

If Yes, please provide details (Where/When/Job Title):

* Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?:

Yes No

If no, please explain:

EMPLOYMENT DESIRED

* When would you be available to begin work?:

* Type of employment desired:

Full-Time
Part Time
Seasonal

* Hourly rate/salary desired:

* Are you currently employed?:

Yes No

If so may we inquire of your present employer?:

Yes No

If presently employed, why are you considering leaving?:

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location	Did you Graduate?	Degree Received	Subjects Studied/Major
	Yes No
	Yes No
	Yes No

If you have completed any special courses, seminars and/or training that would help you to perform the position for which you are applying, please describe:

EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 2

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 3

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

REFERENCES Please provide three references (not relatives).

Name	Relationship	Phone Number	Email

AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

* Signature (type name):

* Date:

Applicant Information

* How did you hear about us?

* Date of Birth

* Drivers License Number

* Social Security Number

* Are you a citizen of the U.S.?

	Yes
	No

* If not, are you authorized to work in the U.S?

	Yes
	No

* Have you ever worked for this company?

	Yes
	No

If so, when?

* Have you ever been convicted of a felony?

	Yes
	No

If so, please explain

* MVR Authorization
Do you authorize East American Inc to run your MVR record?

	Yes
	No

Military Service

Branch:

Years Enlisted:

Rank at Discharge:

Type of Discharge:

If other than honorable, please explain:

Drug and Alcohol Policy Certification

* 1. The drug and alcohol policy covers all East American Inc. employees including CDL Drivers who fall under 49 CFR, Parts 382 of the U. S. Department of Transportation
2. An illegal drug is:
Drugs or controlled substances of which the possession or use of is unlawful
Drugs or controlled substances which are legally obtained but which have been obtained illegally
Prescribed drugs not being used for prescribed purposes or in a prescribed manner.
3. The manufacture, distribution, dispensation, possession, sale or use of illegal drugs by East American Inc's employees on or off the company premises is prohibited.
4. The use, possession, sale or distribution of alcohol, or being under the influence of alcohol on company premises or customer premises is prohibited.
5. All employees are required to undergo drug testing for: pre-employment, random selection, post accident, reasonable suspicion, return-to-duty, and follow up testing. All employees are required to undergo alcohol testing under circumstances of post accident, reasonable suspicion, return-to-duty and follow up.
6. East American Inc. will pay all fees for pre-employment, random, post accident and reasonable suspicion testing.
7. Any employee testing positive for drugs and/or alcohol and who is continuing employment at East American Inc is responsible for fees for any additional testing and for the fees for any required rehabilitation which are not covered by East American Inc's insurance provider. the employer is not responsible for the fees for any additional testing or rehabilitation for employees who are terminated.
8. Any employee who has been informed that he/she has tested positive for drugs and/or alcohol who performs any safety sensitive function for East American Inc is terminated from the moment they begin to drive or perform the function.
9. Whether an employee who tests positive will be terminated or suspended from duty without pay until he/she has undergone rehabilitation is at the sole discretion of the employer.
10. Any employee who refuses to take his/her drug and/or alcohol test will be terminated. A refusal may consist of not proceeding to the testing site in a timely manner, not cooperating during the collection process, or any attempt at adulteration of the testing samples.
11.All employees must sign approval forms agreeing to the testing and authorizing the release or test results to East American Inc's personnel representative and higher management.
12. For CDL drivers, drug testing may require the provision of urine or any sample designated under U. S. Department of Transportation regulations. For other employees drug testing my require the provision of any sample which is considered standard in the drug and alcohol testing industry.
13. Alcohol testing requires breathing into a breathalyzer or a saliva test or any other method designated under 49CFR, Parts 382 and 655 of the U. S. Department of Transportation.
14. East American Inc has a zero tolerance for alcohol use. Thus, the alcohol limits and consequences are:
.02 to .04 - 24 hours suspension without pay
.04 or higher - suspension without pay with a termination option at the sole discretion of the employer
15. Any employee testing .02 to .04 will be suspended from duty for the first offense. At his/her own expense, the employee will be required to have a return-to-duty alcohol test with negative result before returning to duty. Such an incident will serve as the same as written notice and the second occurrence will have the same consequences as a .04 or higher reading.
16. I understand that under East American Inc's policy, I may be tested at any time for drug and/or alcohol abuse whether the tests and/or circumstances is listed under Department of Transportation regulation or not. I understand that the procedures for such tests will follow the standard procedures in the drug and alcohol testing industry.
17. This drug and alcohol policy is implemented for the safety of the general public and for the safety of East American Inc's employees and clients.
18. I have been given the opportunity to read East American Inc's drug and alcohol policies and procedures. I have also been given the opportunity to ask questions and have received sufficient answers about East American Inc's policies and procedures on drug and alcohol abuse.
19. Information on this drug and alcohol program is available from the staff at the drug and alcohol consortium or through the designated representatives of East American Inc this signature certifies that I am aware compliance with this policy is condition of employment at East American Inc and I agree to abide by East American Inc's drug and alcohol policy.
20. If employee leaves East American Inc on their own terms within six (6) months they will be responsible for reimbursing East American Inc the cost for the Drug Screening. This cost is roughly $100.00 for a Drug Screening Test.
By typing your name in the field below, you will be providing the signature for this document.

Signature:

* Date:

Addendum

* East American Inc. has a few additional questions for applicants before submission.
Do you have a commercial driver's license?:

	Yes
	No

If yes, circle one:

	Class A
	Class B

* Do you have a current DOT Medical Card?

	Yes
	No

* Do you have a Tanker Endorsement?

	Yes
	No

* Have you had any preventable accidents resulting in a fatality while operating a commercial motor vehicle in your lifetime?:

	Yes
	No

* Have you had more than ONE non-preventable accident while operating a commercial motor vehicle in the last 3 years?:

	Yes
	No

* Have you had more than TWO moving violations while operating a personal or commercial motor vehicle in the last 3 years?:

	Yes
	No

* Have you had any serious traffic violations while operating a commercial motor vehicle in the last 3 years?:

	Yes
	No

* Have you had any preventable accidents while operating a commercial motor vehicle in the last 3 years?:

	Yes
	No

* Have you ever been convicted for a DUI, DWI, OUI, or reckless driving with alcohol/drugs involved within the last 10 years?:

	Yes
	No

* Have you refused or had any positive drug test results/alcohol test results, either DOT regulated or non-regulated, in the past 5 years?:

	Yes
	No

* Have you had any preventable D.O.T. recordable accidents (fatality, disabled vehicle required towing, requiring medical care) while operating a commercial motor vehicle in the last 10 years?:

	Yes
	No

* By typing your name in the field below, you will be providing the signature for this document.

Addendum Signature:

* Date:

Disclaimer

* In consideration of my employment, I agree to conform to the rules and regulations of this facility. I understand that my employment can be terminated at any time and for any reason, at the option of either the facility or myself. I understand that no one has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except for a written employment agreement signed by an administrative representative of this facility. I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete. I understand that any false or misleading representations or omissions may disqualify me from further consideration of employment and will result in discharge even if discovered at a later date. I also understand any offer of employment is conditioned upon results of post-offer medical examination which includes a drug screening. I hereby authorize persons, schools, my current employer (if applicable) and previous employers and organizations named in this application (and accompanying resume, if any, to provide this facility and all affiliates with any relevant information regarding an employment decision, and I release all such persons from any liability regarding the provision or use of such information. East American Inc. is an equal opportunity employer. No person shall be discriminated against on account of race, color, religious creed, national origin, ancestry, sex, disability or status as a veteran or any other unlawful basis.
By typing your name in the field below, you will be providing the signature for this document.

Signature:

* Date:

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