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Work with West

Employment Application

General Information

First

MI

Last

Address

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Phone Number

Alternate Phone Number

If under the age of 18, please list your age…

Email *

Job Type

Which company would you like to apply?

N.B. West Contracting

Sullivan Asphalt Plants

I am seeking a…

Heavy Equipment Operator

Laborer – Asphalt Ops

Laborer- General Construction Ops

Laborer- Asphalt Plant

Oil Haul Driver

Equipment Hauler

Carpenter

Cement Mason

Quality Control- Materials Testing Division

Office – Admin

Project Manager & Estimator – Asphalt Operations

Project Manager & Estimator – General Construction Operations

Finance Dept

HR Dept

Safety Dept

Material Sales Division

OtherOther

Date available to begin…

Additional Information

Have you ever been employed by this organization in the past? *

Yes

No

Referral Source:

I certify that I am a U.S. Citizen, permanent resident, or a foreign national with authorization to work in the United States. *

Yes

No

Gender

Male

Female

Prefer to not say

Are you hispanic or Latino?

Yes

No

(A person of Cuban, Mexican, Puerto Rican, South or Central american, or other Spanish culture or origin.)

Please Identify your race by selecting one or more of the following.

American Indian or Alaskan Native

Black or African American

Asian

Native Hawaiian or Other Pacific Islander

Two or More races

Not Disclosed

Do you have a driver’s License? *

Yes

No

Driver’s License Number

Issued in what state?

Do you have a CDL License?

Yes

No

What class?

Do you have a Chauffeur’s License (Class E)?

Yes

No

Have you had any accidents during the past three years?

How many?

Have you had any moving violations during the past three years?

How many?

Do you have any of the following certifications? Check all that apply:

OSHA 10

OSHA 30

Flagger Certification

Are you currently in the union?

Yes

No

What union?

Please enter the name of the union you belong to in the above field.

Qualifications

Are you able to perform the essential functions of the job for which you are applying?

Yes

Yes with reasonable accommodations

No

The next section of this form is a partial checklist of things you may be expected to perform. All data provided is voluntary and is not required in order to submit an Application for Employment. Please expand each Qualifications section below and check those you feel you are qualified to do. Your application will not be judged on this information only.

Heavy Equipment Operator Qualification

Operate a skid steer

Yes

No

What skid steer attachments?

Can Operate an Asphalt Paver

Yes

No

Can Operate a Concrete Paver

Yes

No

Operate a Crusher

Yes

No

Operate a track hoe

Yes

No

Operate a motor grader

Yes

No

Operate a roller

Yes

No

Operate a Mill (Rotomill machine)

Yes

No

Operate a MTV/Shuttle Buggy (Materials Transfer Vehicle)

Yes

No

Operate an Excavator

Yes

No

Operate a Broom Truck

Yes

No

Operate a backhoe

Yes

No

Willing to do manual labor when not operating

Yes

No

Set Heavy Girders

Yes

No

Work with little to no supervision

Yes

No

Work as leadman or foreman

Yes

No

Work on public roadways with traffic

Yes

No

Work in high and low temperatures

Yes

No

Haul Oversized equipment (Class A CDL Required)

Yes

No

Drive a Water Truck (Class B CDL Required)

Yes

No

Laborer Qualification

Lute Asphalt

Yes

No

Flag Traffic

Yes

No

Set up advanced work zones

Yes

No

Operate a distributor/tack truck (requires Class A CDL)

Yes

No

Operate a Screed/Screw

Yes

No

Shovel Concrete, dirt, rock, etc

Yes

No

Carry Lumbar, rebar, etc

Yes

No

Operate electric drill, saw, etc

Yes

No

Operate Concrete Vibrator

Yes

No

Operate hand helkd concrete saw or chain saw

Yes

No

Operate air drill, breaker, and tamper

Yes

No

Operate walk behind concrete saw

Yes

No

Operate Cutting Torch

Yes

No

Work below ground in trenches

Yes

No

Work on public roadways with traffic

Yes

No

Work in high and low temperatures

Yes

No

Haul Oversized equipment (Class A CDL Required)

Yes

No

Drive a Water Truck (Class B CDL Required)

Yes

No

Work with little to no supervision

Yes

No

Work as leadman or foreman

Yes

No

Carpenter Qualifications

Experience in concrete construction/bridge construction carpentry

Yes

No

Operate electric drills and saws

Yes

No

Operate cutting torch

Yes

No

Weld Piling

Yes

No

Plumb and Level forms

Yes

No

Work over water or traffic

Yes

No

Work below ground in trenches

Yes

No

Work up to 10’ to 50 ‘ above ground

Yes

No

Work over water or traffic

Yes

No

Work in low and high temperatures

Yes

No

Read blue prints

Yes

No

Work down inside a cofferdam

Yes

No

Work with little to no supervision

Yes

No

Work as leadman or foreman

Yes

No

High School Education

School

Location (Mailing Address)

Years Completed

Degree/Diploma

College or Business/Trade School Education

School

Location (Mailing Address)

Years Completed

Major

Degree/Diploma

Military

Have you ever been in the Armed Forces?

Yes

No

Date entered service

Are you now a member of the National Guard?

Yes

No

Date Entered service

Specialty…

Work Experience

Company

Name of last supervisor

Phone Number

Address

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Country

Country

HRS/Week

Start Date

End Date

Starting Salary

Final Salary

Your Last Job Title

Reason for leaving (Be specific)

List the Jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact this employer?

Yes

No

References

Exclude Relatives and former employers.

Name

Phone Number

Relation

Submit Your Resume

Maximum file size: 516MB

Signature

Date

Captcha

If you are human, leave this field blank.

N.B. West Contracting Co. is an Equal Employment Opportunity Employer and will not discriminate against any applicant or employee on any grounds prohibited under any federal, state, or local law, including race, creed, color, religion, sex, national origin, age, disability, sexual orientation, gender identity or expression, marital status, veteran status or citizenship. We value diversity and inclusivity, welcoming applicants from all backgrounds. VETERAN-FRIENDLY/EOE.

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