Telephone Numer(s): *

If you are under 18 years of age, can you provide required proof of your eligibility to work?

Have you ever filed an application with us before?

Have you ever been employed with us before? *

Are you currently employed? *

May we contact your present employer *

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment.) *

On what date would you be available for work?

Are you available to work: Full Time Part Time Shift Work Temporary

Are you currently on "lay-off" status and subject to recall?

Can you travel if a job requires it? *

Do you have a valid driver's license? *

Do you have reliable transportation? *

Do you have a fear of heights? *

Have you been convicted of a felony with the last 7 years? *
Conviction will not necessarily disqualify an application from employment.)

If yes, please explain:

High School

College/University

Graduate/Professional

Describe any specialized training, apprenticeshop, skills and extra-curricular activities:

Describe any honors you have received:

State any additional information you feel may be helpul to us in considering your application.

Indicate any foreign languages you can speak, read and/or write

Speak:

Read:

Write:

List professional, trade, business or civic activities and offices held.

References:
Give name, address and telephone number of three references who are not related to you and are not previous employers.

Name:

Have you ever had any job related training in the United States Military ? *

Are you physically capable of performing the duties of the job for which you are applying? *

Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.

1. Employer: *

Work Performed: *

Address: *

Telephone Numbers: *

Job Title: *

Reason for Leaving: *

2. Employer: *

Work Performed: *

Address: *

Telephone Numbers: *

Job Title: *

Reason for Leaving: *

3. Employer:

Work Performed:

Address:

Telephone Numbers:

Job Title:

Reason for Leaving:

Special Skills and Qualifications:
Summarize special job related skills and qualifications acquired from employment or other experience.

Pittsburg Tank & Tower requires, as a condition of employment, and/or continued employment that all applicants consent to and authorize verification of the information submitted on their application or resume. Please read this statement carefully.

This release and authorization acknowledges that Pittsburg Tank & Tower may now, or at any time while I am employed, conduct a verification of my education, employment history, credit history, and motor vehicle records including accident history. In addition I understand that an Investigative Consumer Report may be requested and I understand that this report may include information as to my character, general reputation, personal characteristics, mode of living, work habits, performance and experience, along with the reasons for termination of past employment, whichever are applicable, obtained through personal interviews with associates and personal references who have knowledge concerning such items of information. In addition Pittsburg Tank & Tower may require that I provide a urine specimen to be tested for the presence of drugs or alcohol, and may request and receive any record of criminal history or other relevant information pertaining to me which may be in the files of any Federal, State or Local criminal justice agency, and/or other information as deemed necessary to fulfill the job requirements.

I have read and understand this release and consent and authorize the background verification. I authorize persons, schools, current and former employers, and other organizations and agencies providing such information from any and all claims of damages in connection to their release of any requested information. I agree that any copy of this document is as valid as the original.

I authorize Reference Services, Inc. and any of its agents and/or employees to disclose verbally and in writing the results of this verification process to the designated authorized representatives of Pittsburg Tank & Tower. The results may be used to determine employment eligibility under this Company’s employment policies.

I do hereby agree to forever release and discharge Pittsburg Tank & Tower, its agents, Reference Service, Inc, its agents as well as any and all agencies providing such information to the full extent permitted by law from any claims, damages, losses, liabilities, cost and expenses, or any other charger or complaint filed with any agency arising from the retrieving and reporting of information. According to the Federal Fair Credit Reporting Act, I am entitles to know if employment was denied based on information obtained by my prospective employer, and to receive, upon request, a disclosure of the public record information and of the nature and scope of the investigative report. If I am a resident of Minnesota, California or Oklahoma only and would like a copy of the investigative report, I will check here __.

I, the undersigned applicant, do hereby certify that the information provided by me for the purpose of employment is true and complete to the best of my knowledge. I understand that if I am employed, any false statements will be considered as cause for possible dismissal. I also acknowledge that any employment with Pittsburg Tank & Tower is at will employment and either the company or the employee can terminate the employment relationship at any time, with or without cause, with or without notice.

I certify the answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed six months. Any applicant wishing to be considered for employment beyond that time period should inquire as to whether or not applications are being accepted at that time.

I hereby verify that I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge an Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, that I am required to abide by all rules and regulations of the employer. Pittsburg Tank & Tower is a drug free work place. All prospective employees are required to submit to drug testing. Employment is subject to successfully passing a drug test(s).

I understand that clicking the accept button below is the equivalent of my signature on this application.