Employment Application

A Full Service Traffic Control Company

All employees must be capable of the following:

  • Sit for approximately 1-3 hours (or more) driving and operating a company vehicle or riding as a passenger.
  • Walk on level and uneven surfaces for up to 24 consecutive hours.
  • Continuously bend, twist, kneel and crouch for up to 24 consecutive hours.
  • Occasionally climb in and out of slightly lifted vehicle.
  • Continuously reach above and below shoulders for lifting.
  • Continuously grasp and or squeeze with both right and left hand.
  • Must be able to frequently lift 21 to 50 pounds from ground to approximately 54” in height or vice-versa throughout the work day.

Items included but are not limited to:

  • Cones- 7 to 10 Lbs. each no more than 5 lifted or carried at a time.
  • Sign Stand- Approximately 30 Lbs.
  • Various signs- Weight varies but does not exceed 50 Lbs.
  • Barricades- Weight varies but does not exceed 50 Lbs.
  • Items listed above may also be carried up to 500 feet or more.
  • Must be able to occasionally push and pull arrow boards and message boards weighing over 50 lbs.
  • Must be able to continuously work outdoors in extreme cold and heat.
  • Must be able to work in rain, snow or other inclement weather.
  • Must be able to work in conditions with dust, fumes and noise.
  • Must have bladder and bowel control due to the duration of flagging conditions.
  • Must be able to effectively communicate in English.
  • Must be able to understand, read and write basic documents in English.
  • Must have basic math skills (addition and subtraction).
  • Must be able to operate two-way radio and communicate.

APPLICATION FOR EMPLOYMENT

APPLICANT: PLEASE READ AND SIGN BEFORE SUBMITTING THIS APPLICATION.

I understand that the information in this application will be used and that prior employers will be contacted for purposes of investigation required by 391.23 of the Motor Carrier Safety Regulations.

ADDRESS

ADDRESS FOR PAST THREE YEARS (If Different then above)

EMERGENCY NOTIFICATION

EDUCATION

EMPLOYMENT

EMPLOYMENT HISTORY

ATTACH SHEET IF MORE SPACE IS NEEDED (D.O.T. REQUIRES THAT EMPLOYMENT FOR PAST 10 YEARS BE SHOWN)

LAST EMPLOYER

SECOND LAST EMPLOYER

THIRD LAST EMPLOYER

EXPERIENCE AND QUALIFICATIONS- DRIVER

DRIVER LICENSES HELD IN PAST 3 YEARS MUST BE SHOWN

DRIVING EXPERIENCE

CLASS OF EQUIPMENT

STRAIGHT TRUCK

TRACTOR/SEMI TRAILER

TRACTOR-2 TRAILER

OTHER

ACCIDENT RECORD FOR PAST 5 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED)

TRAFFIC CONVICTIONS AND FORFEITURES FOR PAST 5 YEARS (OTHER THAN PARKING VIOLATIONS)

TO BE READ AND SIGNED BY APPLICANT

It is agreed and understood that any misrepresentations and information given above shall be considered an act of dishonesty and may result in termination. It is agreed and understood that that the employer and its agents may investigate the applicants background to ascertain and all information of concern to applicants record, whether same is of record or not and applicant release employers and persons named herein from all liability for any damages on account of his furnishing such information. The applicant agrees to furnish such additional information and complete such examinations as may be required to complete his employment file. It is agreed and understood that application for employment in no way obligates the employer to employ the applicant. It is agreed and understood that if hired, the employee may be on a probationary period during which time he may be discharged without recourse.

This certifies that this application was completed by me and that all entries and information on it are true and complete to the best of my knowledge.

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