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J.W. Tharpe Construction

Job Application

Birthday
Month
Day
Year

Contact Information

Multi-line address

Position Information

Position

Hours: (Check all that apply)

Full Time
Part Time
Regular
Temporary
Do you have an OSHA 10 or 30?
Yes
No
If so, which one?
OSHA 10
OSHA 30
Are you authorized to work in the U.S. on an unrestricted basis?
Yes
No
Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment)
Yes
No
Can you perform the essential functions of the job with or without reasonable accommodation?
Yes
No
Do you have transportation to get to and from work?
Yes
No

Reference 1

Reference 2

Experience

Do you have a High School Diploma or GED?
Yes
No

Work History

Have you ever worked in Civil Site Construction work before?
Yes
No
Start Date
Month
Day
Year
Are you currently employed here?
Yes
No
If yes, may we contact your current employer?
Yes
No
End Date
Month
Day
Year
Start Date
Month
Day
Year
Are you currently employed here?
Yes
No
If yes, may we contact your current employer?
Yes
No
End Date
Month
Day
Year

Submittal Statements (check all boxes)

CONTACT US

For any inquiries or questions contact us:

PHONE

123-456-7890

MAIN OFFICE

4677 Drakes Main St.
Drakes Branch, VA
23937

OFFICE HOURS

Monday - Friday:
9AM - 5PM

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Customer Service
Main Office
434-568-2001
Mary Tharpe
Office Administrator
Harvey Lee
Safety Coordinator
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