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All applicants will receive consideration without regard to race, color, religion, creed, sex, age, national origin, disability, marital status, or veteran status. In reading and answering the following questions, please keep in mind that none of the questions are intended to imply consideration of any non-job-related information.

* Required

Name:  *

Address:  *

City: State: Zip:

Phone: Email:  *

Are you 18 years of age or older? Yes No

Are you 16 years of age or older? Yes No

If offered employment, can you furnish proof that you are eligible to work in the United States? Yes No

WORK PREFERENCE

Are you applying for: Full-time, Part-time, or Summer employment?

For what job are you specifically applying?

Date Available: Can you work any shift? Yes No

Have you ever been previously employed by this company? Yes No

Who referred you to us for employment?

Do you have any relatives working here? Yes No
If yes, please name:

EDUCATION

High School:
Graduated? Yes No

Trade School:
Graduated? Yes No

College:
Graduated? Yes No

Other:
Graduated? Yes No

Please list any vocational or other work-related courses you have completed.

If you graduated from college, what was your degree?

MILITARY

Have you ever served in the Armed Forces? Yes No
Date Entered: Date Left:

Have you ever been convicted of a felony, misdemeanor or any offense other than a minor traffic violation? Yes No
Please explain

WORK HISTORY

Current or Last Employer:

Address:

Phone:

Job Title:

Supervisor Name & Title:

Number Supervised by You:

Date Employed (mo/yr): Date Separated (mo/yr):

Starting Salary: Ending Salary:

Reason for Leaving:

May we Contact Employer? Yes No

Duties:


Previous Employer:

Address:

Phone:

Job Title:

Supervisor Name & Title:

Number Supervised by You:

Date Employed (mo/yr): Date Separated (mo/yr):

Starting Salary: Ending Salary:

Reason for Leaving:

May we Contact Employer? Yes No

Duties:

Resume:
(Please submit only .txt, .doc, .rtf or .pdf files)

Certification of Application and Understanding

I hereby certify that all statements made in this application and any attachments to it are true. I understand that any misstatement, misrepresentation or omission of fact may be cause for my application not to be considered; or, if I have been employed, may be cause for my immediate dismissal. I authorize Human Resources to verify information contained in this application and attachments. I authorize the release of any and all reference information by my past and present employers, references and educational institutions. I understand I may be required to complete a post-offer health assessment that may include a drug test. I understand that this application is not a contract of employment or an offer of a contract of employment, express or implied, between me and The Pike Company and that if I should become employed by The Pike Company, my employment shall be at will, which means that it may be terminated by me or by The Pike Company at any time, for any reason or no reason, with or without notice.