Please fill out the job application below.
Please choose the highest grade or # of years completed in each category:
Please list most recent employer first. Attach other sheets if needed below. This section must be completed even if a resume is attached.
If none, please state "None".
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this on this application shall be grounds for my dismissal. I authorize investigation of all statements contained herein and references listed to give you any and all information concerning my previous employment and release all parties from liability for any damage that may result from furnishing same to you. I understand that this employment application does not constitute a contract of employment, and that, if hired, my employment is for no definite period and may be terminated at any time for any or no reason without notice. I authorize Easton Concrete to request and obtain my law enforcement and motor vehicle records for considering my application for employment. I understand that as a DOT employer, Easton Concrete, Inc. is required to obtain specific past employment and drug and alcohol-testing information as outlined below. I acknowledge that any offer of employment is conditional upon my successful completion of a DOT physical examination and drug screen as part of Easton concretes pre-employment policy. I further understand that if employed I will be subject to alcohol and/or drug testing for random, post-accident, return to duty, and reasonable cause as part if Easton Concretes Substance Abuse Policy.
Easton Concrete complies with Federal Motor Carrier Safety Regulations and, therefore, must investigate, at minimum, information from all previous employers that employed you to operate a commercial motor vehicle within the previous three years. The investigation request will contain general driver identification and employment verification information and data for accidents as defined by the regulations in the three-year period preceding the date of the employment application. Easton Concrete must also request information from all previous DOT regulated employers
that employed you within the previous three years from the date of the employment application in a safety sensitive function that required alcohol and controlled substance testing specified by 49 CFR part 40 of the regulations. The investigation request will include whether, within the previous three years, you had violated the alcohol and controlled substances prohibitions under the regulations and whether you failed to undertake or complete a rehabilitation program prescribed by a substance abuse professional (SAP) pursuant to the regulations. If the previous employer does not know this information, Easton Concrete must obtain documentation of your successful completion of the SAP’s referral directly from you. For a driver who had successfully completed a SAP’s rehabilitation referral, and remained in the employment of the referring employer, information on whether the driver had the following testing violations subsequent to a completion of a referral must be obtained: alcohol tests with a result of 0.04 of higher alcohol concentration; verified positive drug tests; refusals to be tested (including verified adulterated or substituted drug test result).
The following are your rights regarding the investigative information outlined above that is obtained by Easton Concrete:
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.