Employment Form – Crews Control LLC

First Name:

Last Name:

Middle Initial:

City:

State:

Zip:

Please provide your 5 or 9 digit zip code

Main Phone Number:

Other Phone Number:

Email:

Employment Pre-Qualifications

Are you 18 years of age or older?
YesNo

Are you a Veteran of the Armed Forces?
YesNo

Do you have a valid driver's license?
YesNo

If hired, can you provide documents required ESTABLISHING your eligibility to work in the US?
YesNo

Have you ever been convicted of, or pled guilty or no contest to, a crime other than a minor traffic accident?
NoYes If yes, please explain in some detail and include date of final disposition of the case and the nature of the offense. This information will not necessarily disqualify you from employment but false or misleading information will.

Employment Desired

Employment Position
Traffic ControlOfficeOther

Employment Type
Full-TimePart-TimeTemporarySeasonal

Date Available for Work?

Are You currently employeed?
YesNo

Pay Desired?

Payment Type?
HourlyWeeklyMonthlyAnnually

Do you belong to a Union
NoYes If yes, please provide the Local #

Are you willing to travel more than 2 hours (one way) to work?
YesNo

Flagging Experience

I certify that the facts contained in this application are true. I understand that employment with Crews Control, LLC. is at-will, meaning that I or Crews Control, LLC. may terminate my employment at any time, or for any reason consistent with applicable state or federal law.

I authorize Crews Control, LLC. to conduct a thorough background investigation of my work andpersonal history, and verify all data given on this application and during interviews. I hereby release the Organization and its representatives or agents, from any liability that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information.

I certify that I have received, read and understand Crew Control, LLC. EEO Policy Insert.

Contact Information

Employment Pre-Qualifications

Employment Desired

Flagging Experience