Apply Today Apply Today Name First Last Last Complete Address (include: include: street address, city, state, and zip) * Phone * Email Are you currently employed? * Yes No Which position do you want to apply for? (Please check all that apply) * Striping Seal Coating Paving Concrete Mechanic Estimating Admin How did you hear about the position? Online Jobsite Referral Other If you answered "other," please explain: Will you be able to provide proof of eligibility to work in the U.S. if hired? * Yes No Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? * Yes No Experience Summarize your experience, qualifications, training or skills which you feel make you especially suited for working at Anderson Striping. Please indicate only work related information. * Tell us about your motivation to work at Anderson Striping. Also, are you ok with weekend, night time and overtime work? * Past Employment and References Provide your Employment record for at least the last 3 years (employer, position held, and reason for leaving) * Name of past employment work references with phone numbers, email addresses (if applicable), and relationship to named reference. * Please complete for positions that require driving. (If not applying for position that requires driving, type or click N/A in the following questions and skip to the Acknowledgments section.) Driver Qualifications (Class, State, Expiration date) Approximately how many years of work related driving experience do you have? What type of trucks, trailers, equipment, etc do you have experience driving/hauling? Acknowledgements (part 1) By my signature below (typed name), I affirm that I have read and understood this application, that l have not withheld any information requested, and that any statements I have made are true and correct. I understand that any omission or misrepresentation of fact in this application or on the resume I submitted may result in refusal of or separation from employment. I authorize verification and investigation of the statements I have made in this application as well as the resume I have submitted. I understand that if I am offered employment by Anderson Striping; reference and background checks will be performed, a current DMV record must be submitted, and a drug test must be performed. Anderson Striping reserves the right to withdraw any offer made based upon the outcome of the drug test, DMV record review, and reference and background checks. Any offer will be contingent upon favorable outcomes for the reference and background checks, DMV record review, and the drug test. I request, authorize and consent to the release of information to Anderson Striping regarding my previous employment and authorize all past employers or agents that they may designate to respond to verbal or written inquiries from Anderson Striping regarding my employment record. I further hereby release and hold harmless Anderson Striping, its officers, employees and agents, and any other person, or public or private entity inquiring about, investigating, furnishing, communicating, reviewing or evaluating information or documents in good faith and without malice pursuant to this request, authorization, consent and release, or making any written or verbal communications for such purposes, from any and all claims arising from such activities. Signature: Please type your name stating you agree to the above Acknowledgement (part 1) * Acknowledgements (part 2) In consideration of my potential employment, I agree to conform to the rules and regulations of Anderson Striping Company. If I am hired, I understand my employment is at-will and employment can be terminated with or without cause, with or without notice, at any time at the option of Anderson Striping or me. I understand that nothing contained in this application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Anderson Striping. No representative, employee, or assignee of Anderson Striping itself, other than in writing by its President, has any authority to enter into any agreements with me for employment for any specified period of time or to make any agreement contrary to the foregoing. Signature: Please type your name stating you agree to the above Acknowledgement (part 2) * Permission for Motor Vehicle Report (MVR) There is no cost to you when Anderson Striping pulls your MVR. As part of the employment process, we must conduct a review of your driving record. By signing below, you grant Anderson Striping permission to access and evaluate your MVR (Motor Vehicle Report). This permission allows Anderson Striping to pull the MVR a single (1) time during the employment process utilizing Samba Safety, a third-party software program Applicant’s Driver’s License Number Applicant’s Date of Birth (MM/DD/YYYY) I authorize Anderson Striping access to the MVR for the Driver’s License Number listed above. (Please type your name stating you agree below) Additional Comments If you are human, leave this field blank. Submit
