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Employment Application

Step 1 of 5

Answer ALL Questions Completely - Please Print - Complete All Applicable Pages ( and attach more pages if needed).

Failure to provide complete, accurate responses to all questions, without material omission, will disqualify you from any consideration for employment with Landwehr Construction, Inc.
Position Applying For*
Please enter the position you are applying for:
How did you hear about us?
Please specify:
Name of Referrer
Date of Application*
MM slash DD slash YYYY
Name*
First Last
Email
Have you ever been known by another name or by an alias?*
- Yes
- No
If yes, what?
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone: (w/Area Code)*
Work phone at which you can be reached
Have you lived at any other addresses in the past 3 years?*
- Yes
- No
List any other addresses you've been at in the past 3 years
Dates Address City State Zip
If hired, can you furnish proof that you are 18 years of age, or older?*
- Yes
- No
If hired, can you furnish proof that you are eligible to work in the United States?*
- Yes
- No
Have you applied for or worked for LCI before?*
- Yes
- No
If yes, when?
Reason for leaving LCI if applicable?
Do you know anyone who is/was employed by LCI?*
- Yes
- No
If yes, who?
Are you available to work any time of the day or week as needed?*
- Yes
- No
Limitations?
Date you can start*
MM slash DD slash YYYY
Desired wage or salary*
Driver's License Information: all licenses held, for the last 3 years*
State Number Class Expiration Date
Upon employment, Landwehr reserves the right to inquire into your driving records (last 3 yrs) from the appropriate State Agency.

Education/Training
Education / Training*
Level of School or Training Name and Location of Training, Apprenticeship, School, Military Branch or other Provider No. of Years Did You Finish? Subjects, Certification, Degree and/or Rank
Have you served in the Military, National Guard or Reserves, even if you received no work-related training?*
- Yes
- No
If yes, which Branch?
Final Rank
If you hold a state journeyperson or any relating licenses, certificates or competency cards, please provide details, including every state or city in which you hold or have ever held such a credential*
Number of license or competency card held
Jurisdiction
Date Issued

Individual's Name	Telephone (w/area)	Address (City, State, Zip)	Type of Business	Years Acquainted

Apply Online

Employment Application

Step 1 of 5

Education/Training

Work History

Equipment Operation Experience

References

ACKNOWLEDGEMENT: PLEASE READ AND SIGN (If you agree)

Affirmative Action Survey

Dates	Address	City	State	Zip

State	Number	Class	Expiration Date

Level of School or Training	Name and Location of Training, Apprenticeship, School, Military Branch or other Provider	No. of Years	Did You Finish?	Subjects, Certification, Degree and/or Rank

Type of Equipment Operated (Ex: dump truck, backhoe, crane)	Dates of Operation From To	Approximate number of operated hours/miles