It is the policy of this company to provide equal employment opportunities to all qualified persons without regard to race, creed, color, religion, sex, sexual orientation, age, national origin, physical or mental handicap, or marital status.

Personal Information

Last Name *

First Name *

Middle Name

Current Address

Street *

City

State

Zip

Mailing Address (if different)

Street

City

State

Zip

Phone *

Cell

Email *

Oregon Driver's License #

Authorized to Work in the U.S.?

YesNo

Position Specifications

Position Applying For

Referred By

Do you currently have a Traffic Control Flagger Certificate?

YesNo

Days Available for Work

SundayMondayTuesdayWednesdayThursdayFridaySaturday

Hours Available

Type of Vehicle You Drive

Willing to travel farther than 60 miles?

YesNo

Willing to temporarily stay away from home?

YesNo

Employment History — Last 4 Employers (most recent first)

Employer 1

Employer Name & Address

Position / Title

From (MM/YYYY)

To (MM/YYYY)

Wage

Reason Leaving

Employer 2

Employer Name & Address

Position / Title

From (MM/YYYY)

To (MM/YYYY)

Wage

Reason Leaving

Employer 3

Employer Name & Address

Position / Title

From (MM/YYYY)

To (MM/YYYY)

Wage

Reason Leaving

Employer 4

Employer Name & Address

Position / Title

From (MM/YYYY)

To (MM/YYYY)

Wage

Reason Leaving

References — 3 Persons Not Related to You

Reference 1 Name

Address or Phone

Business / Relationship

Reference 2 Name

Address or Phone

Business / Relationship

Reference 3 Name

Address or Phone

Business / Relationship

Emergency Contact

Name

Address

Phone

Attestation

I understand that this is an application for employment and does not constitute a contract for employment. Further, I authorize the investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period of time and may, at the discretion of the employer, be terminated at any time without any previous notice.

Signature (Type Full Name) *

Date

Flagging JobsApply in Oregon

Personal Information

Position Specifications

Employment History — Last 4 Employers (most recent first)

References — 3 Persons Not Related to You

Emergency Contact

Attestation

Flagging Jobs
Apply in Oregon