Form Test

Employment Form

General Application for Employment
Century Construction Company, Inc.

All statements made by applicants for employment on this form will be carefully checked for accuracy. We offer equal employment opportunities to all persons without regard to race, religion, age, sex, national origin, or handicap. The use of this form does not mean there are positions open and does not obligate us in any way.

Personal Information

First Middle Last
Home or Mobile Number
Street, City, State, Zip
Are you over the age of 18?
If No, employment is subject to verification that you are minimum age to work.
Type of Employment


Employment History

(Start with the most recent employer)

Employer 1:

Employer 2:

Employer 3:

Have you applied for a job with us before?
Have you ever worked for us before?
Have you ever been convicted of a crime, except a minor traffic violation?
Have you ever been discharged or requested to resign from a position?
The construction industry is a strenuous, outdoor environment. Employees are commonly on their feet all day, walk distances, lift heavy objects, climb ladders, work at heights, operate power tools, operate equipment, reach overhead, drive vehicles, and work in dusty conditions.

Are you able to perform any or all of the following duties? Please check Yes or No for each of the listed Description of Duties. If an explanation is necessary, and more space is needed to explain, continue to write in the box beside your selection.
Can you be on your feet all day?
Can you walk extended distances?
Can you lift heavy objects?
Can you climb ladders?
Can you work at heights?
Can you operate power tools?
Can you operate equipment?
Can you reach overhead?
Can you drive vehicles?
Can you work in dusty conditions?


(Please do not list any relatives or former employers)
“I certify that the information given by me in this application is true in all respects, and I agree that if employed and information is found to be false in any way, that I may be subject to dismissal without notice, if and when discovered. I authorize the use of any information in this application to verify my statements, and I authorize past employers and others to answer all questions asked concerning my abilities, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information.

I further agree, if employed, that I am to work faithfully and diligently, to avoid accidents, to come to work promptly, and, if I am absent for any reason, without prior notice to my supervisor, it is agreed that employment is terminable at the will of either the employee or employer.”
By providing your name in this field, you are agreeing to have this text represent your signature.
Max. file size: 64 MB.