Employment Application For Highway Construction
and Maintenance Jobs

If you have any questions please call our office, (518) 664-9435.

Click Here to download and print our employment application.

* required fields

Personal Data

Last Name *
First Name *
Middle Name
 
Phone Number *
Alt. Phone Number
Email *
 
Physical Address *
Address 2
City *
State *
Zip *
 
Mailing Address *
Address 2
City *
State *
Zip *
 
Do you have your OSHA 10 hour card? *   Yes  No
Do you have a Commercial Driver’s License? *   Yes  No
Are you 18 years of age or older? *   Yes  No
 
If under 18 years of age can you provide proof of eligibility to work? * (Persons under 18 years of age MUST supply working papers) Yes  No
 
Do you have evidence of authorization to work in the United States which you can present if a job offer is made? * Yes  No
 
Have you ever been convicted of a felony? * Yes  No
If Yes, Explain.
 

Education

School Name
City
State
Years Attended?
Graduated? Yes  No
Major/Specialty
List Special abilities, activities, awards, honors.
 
School Name
City
State
Years Attended?
Graduated? Yes  No
Major/Specialty
List Special abilities, activities, awards, honors.
 
School Name
City
State
Years Attended?
Graduated? Yes  No
Major/Specialty
List Special abilities, activities, awards, honors.
 
Have you ever attended a Construction Career Days Event? * Yes  No
 
List any experience or special education received in the military.
If you were in the military, are you a participant in the USAREC Partnership for Youth Success (PaYS) Program? Yes  No
 
Our jobs often require heavy lifting. Can you lift up to 50 pounds regularly during a shift? * Yes  No
 
Please provide any additional information or list any special skills that you have (including training, equipment operation, special tools, or other activities) which you believe would help us in better understanding your qualifications for this job.
 

Work History

Company Name
Address
City
State
Zip
Phone
Dates Worked  From   To
Job Title
Rate of Pay
Supervisor
Reason for Leaving.
May we contact this employer? Yes  No
 
Company Name
Address
City
State
Zip
Phone
Dates Worked  From   To
Job Title
Rate of Pay
Supervisor
Reason for Leaving.
May we contact this employer? Yes  No
 
Company Name
Address
City
State
Zip
Phone
Dates Worked  From   To
Job Title
Rate of Pay
Supervisor
Reason for Leaving.
May we contact this employer? Yes  No
 

Availability

I can work
Full-time
Part-time
Shift Work
Temporary
Weekday Overtime
Weekend Overtime
 
When can you start?
Are you currently on a "Lay-off" status and subject to recall? Yes  No
 

Job Preference

Job Applying For
 
Have you filed and application with us before?  Yes  No
If yes, what date?
 
Can you travel if the job requires?  Yes  No   50 Miles or More