Position(s) for which you are applying:

Today's Date:

*First Name:

Middle Name/Initial:

*Last Name:

*Street Address:

*City:

*State:

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming

*Zip Code:

Home Phone:

Mobile/Alternate Number:

Email Address:

How did you hear about us?

If under age 18, do you have a work permit?

Yes No I am over age 18

If you answered "no", please explain:

*Have you ever been employed by Thissen Construction Corp.?

Yes No

If you answered "yes", please give dates and positions held:

*Are you legally eligible for employment in the USA?

Yes No

When are you available to start?

Enter your desired salary range:

Type of employment desired:

Full-Time
Part-Time
Temporary
Seasonal
Educational Co-op

Work Experience:

Please provide the following information, starting with your most recent employer.

Employer:

Employer's Telephone:

Street Address:

City:

State:

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming

Starting Date:

Starting Job Title:

Starting Salary/Wage:

Starting Bonus/Commission/Other Compensation:

Ending Date (if no longer employed):

Ending/Current Job Title:

Supervisor's Name:

May we contact this employer?

Yes No

If you are no longer employed with this employer, why did you leave?

Summarize the type of work performed and job responsibilities:

What did you like most about this position?

What did you like least about this position?

Employer 2

Employer:

Employer's Telephone:

Street Address:

City:

State:

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming

Starting Date:

Starting Job Title:

Starting Salary/Wage:

Starting Bonus/Commission/Other Compensation:

Ending Date (if no longer employed):

Ending/Current Job Title:

Supervisor's Name:

May we contact this employer?

Yes No

If you are no longer employed with this employer, why did you leave?

Summarize the type of work performed and job responsibilities:

What did you like most about this position?

What did you like least about this position?

Employer 3

Employer:

Employer's Telephone:

Street Address:

City:

State:

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming

Starting Date:

Starting Job Title:

Starting Salary/Wage:

Starting Bonus/Commission/Other Compensation:

Ending Date (if no longer employed):

Ending/Current Job Title:

Supervisor's Name:

May we contact this employer?

Yes No

If you are no longer employed with this employer, why did you leave?

Summarize the type of work performed and job responsibilities:

What did you like most about this position?

What did you like least about this position?

Skills & Qualifications.

Summarize any training, skills, licenses, and certificates that may assist you in performing the position for which you are applying.

Summary of Skills:

Years of word processing experience, if any:

Describe your word processing experience:

Years of email experience, if any:

Describe your email experience:

Years of spreadsheet experience, if any:

Describe your spreadsheet experience:

Years of internet experience, if any:

Describe your internet experience:

Years of presentation experience, if any:

Describe your presentation experience:

Education

Starting with your most recent school attended, provide the following information.

School (Include City/State):

Number of Years Attended:

Completed/Earned:

Diploma Degree Certification GED/High School Equivalency

GPA/Class Rank:

Major/Minor:

School (Include City/State):

Number of Years Attended:

Completed/Earned:

Diploma Degree Certification GED/High School Equivalency

GPA/Class Rank:

Major/Minor:

School (Include City/State):

Number of Years Attended:

Completed/Earned:

Diploma Degree Certification GED/High School Equivalency

GPA/Class Rank:

Major/Minor:

References

Please provide the names and telephone numbers of three business/work references who are not related to you and not previous supervisors. If not applicable, list three school or personal references who are not related to you.

Name of Reference:

Title:

Relationship to You:

Telephone Number:

Years Known:

Name of Reference:

Title:

Relationship to You:

Telephone Number:

Years Known:

Name of Reference:

Title:

Relationship to You:

Telephone Number:

Years Known:

Applicant Statement.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement