Application For Employment
Eagle Rock Concrete, LLC is an Equal Opportunity Employer.
Please Fill Out Entirely.
Date Format: MM slash DD slash YYYY
Please fill out the fields below for any education you have received. Use the plus button on the right to add more rows if you went to multiple schools.
Employment History - Past 10 Years
Notice to all Mixer Truck Driver Applicants: The U.S. Department of Transportation requires that all driver applicants show all employment for the past three years. Effective July 1987, applicants must also show all commercial driver employment for the seven years immediately preceding this three year period (10 years total). 391.21. (b)(10)(11)
Please provide all information.
Click the plus button on the right to add a new row.
Additional Information for Commercial Drivers
The following information is required by the U.S. Department of Transportation, Section 391.21. Your application will not be considered if all information is not furnished.
Please furnish the addresses at which you resided during the 3 years preceding the date on which the application is submitted.
Please furnish the issuing State, number, and expiration of each unexpired commercial motor vehicle operator's license or permits that have been issued to you
Please list below the nature and experience in the operation of heavy equipment, including the type of equipment (such as mixer trucks, loaders, excavators, etc.) which you have operated.
Please list all of the motor vehicle accidents and violations in which you have been involved during the 10 years preceding the date of application.
Notice to Applicant
- All information submitted will be considered in reviewing my application and is subject to investigation. I hereby authorize Eagle Rock Concrete, LLC to investigate all statements applicable, except as indicated.
- I certify that the facts set forth in this employment application are true and complete to the best of my knowledge. I understand that misrepresentation or omission of facts called for is cause for dismissal upon discovery of such information.
- If accepted for employment, I hereby agree to comply with the rules, regulations, and policies of Eagle Rock, LLC.
- I agree, if hired, to periodic checks of my background information by Eagle Rock Concrete, LLC to ensure I am upholding the standards of conduct and good driving record required by Eagle Rock Concrete, LLC for continued employment.
- I understand that Eagle Rock Concrete, LLC is an "At Will" employer and that absolutely no contract of employement is offered nor implied by Eagle Rock Concrete, LLC.
This Background Check form MUST BE COMPLETED for us to consider your application.
Click Here For Background Check Form
Once completed, indicate that you have done so by checking this box.
Drug Program Disclosure and Agreement
As stated in the Associate's Handbook, Eagle Rock Concrete's drug detection policy is as follows:
The illegal use, possession , sale or transfer of alcohol, drugs, controlled substances, and illegal narcotics while on the job or Company property will result in immediate discharge and may result in an investigation by local authorities. Associates and/or applicants will be sunject to testing for drugs and/or alcohol under the following circumstances:
- Pre-employment Testing - All applicants will be given a drug-screening test prior to hire.
- DOT Testing - per DOT regulations
- Reasonable Cause Testing - When a supervisor has reasonable cuase to question an Associate's condition.
- Post Accident Testing - When an Associate is involved in an accident, on or off Company property while on Company time.
- Random Testing - Associates selected at random.
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I have also read and understand the above Notice to the Applicant and Drug Program Disclosure Agreement.
By typing "I Agree" into this box you certify that you agree to the above statements.
Date Format: MM slash DD slash YYYY