| About Us | Timber Bridges | Our Construction | Resource Center |
		| Photo Gallery | Request Information |

Office Employment Application Please answer all questions.  Resumes are not accepted in lieu of this application. Note: This application was designed for use with several types of job positions.  Some questions may not be completely applicable to the job position you are seeking; however, you must answer all questions.   PERSONAL INFORMATION Last Name:    First Name: Middle Name:    SS #:    Date: Street Address: City:    State:    Zip:    Phone: How long at present address? If less than one year, please list previous address below. Street Address: City:    State:    Zip:    POSITION INFORMATION Position Applied For:    Date Available: Please check all that apply: Full time Part time Temporary Seasonal On-call Are you willing to work overtime if necessary? Yes No Only US citizens or aliens who have a legal right to work in the US are eligible for employment.  Can you, upon employment, submit documentation verifying your identity and your legal right to work in the US? Yes No Have you ever been convicted of a crime (other than a minor traffic violation) or enter a plea of guilty or nolo contendre? Yes No If yes, give dates and explain.  "Yes" answers will not necessarily be a bar to employment.  Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. Are you 18 years of age or older? Yes No If under 18, please state your age: Have you ever been employed by York Bridge Concepts? Yes No If yes, when? How many days were you absent from work during the past year due to illness? How did you hear about the position?  Please specify the newspaper, agency, etc. Newspaper: Employee Referral: Internet: Other Ad: Agency: Other: PREVIOUS EMPLOYMENT Beginning with your present or last position, list the jobs that you have held. Employer1:   Supervisor: Hourly Rate/Salary: Starting:    Ending: Address: Phone Number:    Dates Employed:  From:   To: Position Held:    Reason for Leaving: Work Performed: Employer2:   Supervisor: Hourly Rate/Salary: Starting:    Ending: Address: Phone Number:    Dates Employed:  From:   To: Position Held:    Reason for Leaving: Work Performed: Employer3:   Supervisor: Hourly Rate/Salary: Starting:    Ending: Address: Phone Number:    Dates Employed:  From:   To: Position Held:    Reason for Leaving: Work Performed: EDUCATION May or may not be considered depending on job applied for.  Please begin with most recent school. School1:     Address: # of Years Attended:    Field of Study:   Degree: School2:     Address: # of Years Attended:    Field of Study:   Degree: School3:     Address: # of Years Attended:    Field of Study:   Degree: OTHER INFORMATION Please summarize special job-related skills or qualifications including licenses and certificates (please give registration number, state and expiration date) acquired from employment or other experience, which relates to the job for which you are applying. In order to permit a check of your work and educational records, should we be made aware of any name change or assumed name you used previously? Yes No If yes, please identify names and relevant dates. List any relatives who are currently employed by us: Name:    Relationship: Name:    Relationship: References: Please give the name, address, telephone number and company of two character references who are not related to you and are previous employers. 1. 2. Please give the name, address, telephone number of two character references not related to you. 1. 2.

© 2004 by York Bridge Concepts, Inc. - 1419 W. Waters Ave. #116 - Tampa, FL 33604 - 800.226.4178