Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

If hired, can you provide evidence of legal eligibility to work in the U.S.?*

*Any offer of employment is conditioned upon completing form I-9 and providing appropriate documents for identity and work authorization.

Position you are applying for:

Location you are applying for:

Wage/Salary Desired

Date you can begin work

Are you 18 years of age or older?

If under 18 years of age, you will be required to submit a birth certificate or work certificate as required by state or federal law.

How did you hear about us?

Choose one:

Name of person who referred you OR Other:

Have you worked at CBP before?

If yes, provide start and end dates:

Have you ever been convicted of a crime other than a routine traffic offense?

Do you currently have any criminal charges pending against you?

Name of high school attended

City, State

Did you...

Name of college or technical school

City, State

Major

Degree completed

Are you presently enrolled in school?

Skills, Accomplishments, Military Service

List any job-related skills or accomplishments, including military service.

AVAILABILITY FOR WORK

Check the days you are available for work:

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY

Total hours available per week

e.g. 40

Do you have any special requests or needs for a work schedule?

If yes, please describe them below.

EMPLOYMENT HISTORY

May we contact current employers before you are offered a position?

EMPLOYER 1

Job Title

Start Date

YYYY

End Date

YYYY

Name of Employer

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Starting Pay

Ending Pay

Supervisor

Duties

Describe your duties

Reason for leaving

Why did/are you leaving this position?

Name of Employer 2

Job Title

Start Date

YYYY

End Date

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Starting Pay

Ending Pay

Supervisor

Duties

Describe your duties

Reason for leaving

Why did/are you leaving this position?

Name of Employer 3

Job Title

Start Date

YYYY

End Date

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Starting Pay

Ending Pay

Supervisor

Duties

Describe your duties

Reason for leaving

Why did/are you leaving this position?

Note to applicants: The following is a brief job description.

Summary/Objective The heavy equipment operator operates a variety equipment and trucks used in construction, maintenance and repair activities and performs a variety of semiskilled tasks in the construction of landfills. Essential Functions Operates construction or power equipment, such as backhoe, man-lift, dump truck, bulldozer, road grater, front-end loader, hydraulic excavators, skid steers, packers etc. All heavy equipment operators will be required to perform ground work from time to time this will include picking up rocks, sticks and roots as well as using a manual shovel. Performs all duties in conformance to appropriate safety and security standards. Work Environment While performing the duties of this job, the employee regularly works in outside weather conditions including but not limited to hot, cold, wet, dry. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Additional Information All heavy equipment jobs will require you to work out of town for a minimum of (5) days at a time with the possibility of working over-time and weekends and travel from site to site. Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given.

YES

Applicant Agreement

I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby 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 the 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, also, that I am required to abide by all rules and regulations of the employer. I understand that if offered a position with CBP Environmental, Inc., I may be required to submit to a post-employment offer background check, post-employment offer drug test and, post-employment offer fit for duty physical as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these post-employment offer checks will result in withdrawal of any employment offer or termination of employment if already employed.

AGREE

DISAGREE

Applicant Signature

First Name

Last Name

CDL DRIVER CLASS A