You may fill out our online
application below, or you may print a
paper application by clicking HERE.
Please complete this form as much as possible.
If a question doesn’t apply to you or
you don’t know the answer, please leave
it blank and skip ahead to the next question.
When the form is complete, click the “Submit”
button at the bottom of the page. The
information provided here will be kept
confidential and will only be used by
the Brewer Crane hiring committee.
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| Last name: |
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| First Name: |
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| Middle Initial: |
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| Permanent Street Address: |
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| City: |
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| Zip: |
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| Phone Number: |
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| Cell Phone Number: |
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| E-mail Address: |
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| Position Desired: |
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| Date You Can Start: |
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| Wage/Salary Desired: |
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| Are you currently employed? |
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| If so, may we inquire of your present employer? |
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| Education History |
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| If you attended any of the following schools, please fill in the corresponding information: |
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| Name of high school: |
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| Did you graduate high school? |
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| If not, do you have a GED? |
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| Name of College (if applicable): |
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| Number of years attended? |
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| Did you earn a degree? |
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| If yes, what is your degree? |
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| Did you attend a trade or business school? |
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| How many years did you attend? |
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| Did you complete the program? |
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| General Information |
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| Check all departments that you are experienced in: |
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Crane Operation
Rigging
Truck Driving |
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| Are you NCCCO certified to operate a crane? |
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| If yes, please check the cranes in which you are certified: |
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Tower Crane
Lattice Boom Crawler
Lattice Boom Truck
Small Hydraulic
Large Hydraulic |
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| Do you currently have a Class A driver's license? |
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| Are you familiar with welding and/or fabrication? |
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| Do you have any experience as a mechanic? |
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| Please tell us any other information about yourself in five or fewer sentences: |
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Employment Information |
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| Please list your last four employers, starting with the oldest. |
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| Name of oldest employer: |
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| Phone number of oldest employer: |
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| How long were you with this employer? |
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| What position did you hold with this employer? |
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| What was your wage/salary with this employer? |
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| What was your reason for leaving this employer? |
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| Name of second employer: |
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| Phone number of this employer: |
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| How long were you with this employer? |
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| What position did you hold with this employer? |
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| What was your wage/salary with this employer? |
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| What was your reason for leaving this employer? |
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| Name of third employer: |
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| Phone number of this employer: |
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| How long were you with this employer? |
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| What position did you hold with this employer? |
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| What was your wage/salary with this employer? |
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| What was your reason for leaving this employer? |
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| Name of most recent employer: |
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| Phone number of this employer: |
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| How long were you with this employer? |
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| What position did you hold with this employer? |
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| What was your wage/salary with this employer? |
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| What was your reason for leaving this employer? |
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| References |
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| Please provide the information for three persons, not related to you, whom you have known at least one year: |
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| Name of first reference: |
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| Phone number for this reference: |
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| How do you know this person? |
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| Name of second reference: |
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| Phone number for this reference: |
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| How do you know this person? |
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| Name of third reference: |
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| Phone number for this reference: |
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| How do you know this person? |
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| Authorization |
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"I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements on this application shall be grounds for dismissal."
"I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information."
"I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."
"This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws." |
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| If you agree to the above statement please check here: |
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I agree to the statement above |
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| Please give your initials: |
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