Home 9 Application Non-CDL Application (NON-CDL) Employment (non-CDL) Step 1 of 7 14% Please complete the entire application It is the policy of Lanracorp to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran statusApplicant InformationFull Name* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you lived at your current address? Email* Phone Number*Position Applied for Full or Part Time?* Full Time Part Time Requested Pay Rate Who referred you to our company? Do you have any friends or relatives who work here? If yes, please list here: Have you applied to our company previously?* Yes No If yes, when? Are you at least 18 years old?* Yes No If applicable, are you available to work overtime?* Yes No If you are offered employment, when would you be available to begin work? If hired, are you able to submit proof that you are legally eligible for employment in the United States?* Yes No “In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.” SkillsList any skills that may be usefulfor the job you are seeking. Enter the number of years of experience.SkillYears Experience Add more rows by hitting the plus (+) icon to the right of the fields.Employment HistoryList your current or most recent employment first. Please list all jobs(including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment. Add more rows by hitting the plus (+) icon to the right of the fields.Employer NameSupervisor NameAddressCity/State/ZipJob DutiesReason for LeavingDates of Employment (Month/Year) Can we contact the previous employers listed? Yes No Please fill out the attached form and send to hr@lanracorp.com. Reference Checking Consent and Authorization Form Education & TrainingCollege/University Name and Address Did you receive a degree? Yes No If yes, degree(s) received: High School/GED Name and Address Did you receive a degree? Yes No Other Training (graduate, technical, vocational): Please indicate any current professional licenses or certifications that you hold: Awards, Honors, Special Achievements: Military Service: Yes No Branch: Timeline of Service Specialized Training: ReferencesList any two non-relatives who would be willing to provide a reference for you. Name* Address* City/State/Zip* Phone* Relationship* Name Address City/State/Zip Phone Relationship Please provide any other information that you believe should be considered?How did you hear about Lanracorp? Online Jobsite (IE Indeed, unemployment website, etc) Social Media (IE Facebook) Sign/Billboard/Company Trucks Recommendation Other If Other, please describe If recommended by someone, please tell us their name. Do you currently have OSHA Certification?* Yes No If “Yes”, which type (IE, OSHA 10 or OSHA 30)* Do you have CURRENT pipeline safety training certification?* Yes No If yes, what type? Do you have current OQ Training?* Yes No If “Yes” when was your last testing date? How many years of work-related experience do you have with the following equipment? (Leave blank if no experience)Chain SawLine FinderSkid SteerAriel Lift AssessmentHow many years of equipment operator/tree removal experience do you have? Do you have a valid driver's license?* YES NO Are you willing to get a class A CDL permit?* YES NO Are you willing to get one before you start?* YES NO Are you willing to do a pre-employment drug and alcohol test?* YES NO Are you authorized to work in the US?* YES NO Are you willing to undergo a background check, in accordance w/ local laws/regulations?* YES NO Are you willing to travel for work?* YES NO Certification and SignatureI certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize Lanracorp to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its President, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Lanracorp, except in a specific written contract of employment signed on behalf of the organization by its President, has the power to alter or vary the voluntary nature of the employment relationship. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.Date MM slash DD slash YYYY 66550 ="check=First Choice,Second Choice" theme="orbital"]
