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1 Employment Application Equal Opportunity Employer Drug Free Workplace Solicitud de empleo Empleador que ofrece igualdad de oportunidades Lugar de trabajo sin drogas You must complete entire application and sign where indicated. Debe completar la solicitud en su totalidad y firmar donde se indica. Applicant Information Información del solicitante Name (first, middle, last) Nombre (nombre, segundo nombre, apellido) Date: Fecha: Address (street, city, state, zip code). Dirección (calle, ciudad, estado, código postal) Dirección de correo electrónico: Are there other names under which you have worked or attended school? Yes No If yes, please list for reference checking purposes. Ha trabajado o estudiado con algún otro nombre? Sí No Si la respuesta es afirmativa, indíquelos para chequear las referencias. Are you legally authorized to work in the U.S.? Yes No (If hired, you will be required to provide proof of work authorization.) Está autorizado para trabajar en EE. UU. legalmente? Sí No (Si se lo contrata, deberá proporcionar evidencias de estar autorizado a trabajo.) Mobile Teléfono móvil ( ) - Home Teléfono de la casa ( ) - Are you at least 18 years old? Yes No If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit. Tiene al menos 18 años de edad? Sí No Si la respuesta es negativa, su empleo estará sujeto a verificación de que cumpla los requisitos estatales/federales de edad mínima para el tipo de trabajo para el que está solicitando empleo y haya obtenido un permiso de trabajo válido. Have you ever been convicted of a crime or pleaded no contest for any offense or violation other than minor traffic violations? Yes No If Yes, explain 1) nature of crime, 2) date of conviction, and 3) state in which convicted. (Convictions are not an automatic bar to employment.) Alguna vez lo han condenado de un delito o no ha disputado los cargos por cualquier delito o infracción que no fuera una infracción de tránsito? Sí No Si la respuesta es afirmativa, explique 1) tipo de delito, 2) fecha de la condena y 3) estado donde lo condenaron. (Las condenas no son automáticamente un impedimento para el empleo.) Do you have any pending criminal charges against you? Yes No If Yes, describe the 1) nature of the charges, 2) date issued, and 3) county and state where issued. Tiene algún cargo delictivo pendiente contra usted? Sí No Si la respuesta es afirmativa, describa 1) tipo de cargo, 2) fecha de imputación y3) condado y estado donde se le haya imputado.
2 Have you ever applied at this company before? Yes No If yes, when: Have you ever worked at this company before? Yes No If yes, when: Alguna vez solicitó empleo en esta compañía antes? Sí No Si la respuesta es afirmativa, cuándo: Position Applying For Puesto que está solicitando Part-Time or Full-Time Desired Tiempo parcial o tiempo completo deseado Alguna vez ha trabajado para esta compañía antes? Sí No Si la respuesta es afirmativa, cuándo: Hourly Pay Expectation Pago por hora - Expectativa When can you start? Cuándo puede comenzar? How were you referred to the company? Agency Website Friend/Relative Social Media School Other Cómo fue derivado a la compañía? Agencia Sitio web Amigo/Pariente Redes sociales Lugar de estudios Otro Please list any friend or relatives that employed with R.A.W. Construction. Indique cualquier amigo o pariente que esté empleado en R.A.W. Construcción. Education Educación School Entidad educativa High Secundaria College Universidad Training Courses Cursos de capacitación Name & Location (city, state) Nombre y lugar (ciudad, estado) Number of Years Attended Cantidad de años que asistió List any relevant training programs completed. Indique todo programa de capacitación pertinente completado. Course/Seminar Curso/Seminario Organization Sponsoring Empresa patrocinadora Major subjects Materias principales Content Contenido Diploma or Degree Received Diploma o título recibido Yes Sì Yes Type: Sì Tipo: No No No No Date(s) Attended Fechas en las que asistió
3 License(s) Licencia(s) Do you have a valid driver s license? Yes No License Class: Tiene una licencia de conducir válida? Sí No Clase de la licencia: Do you have car insurance? Yes No State Issued: Tiene seguro de automóvil? Sí No Estado que lo expidió: Do you have a valid Commercial Driver License? Yes No Endorsements? Tiene una licencia de conducir comercial válida? Sí No Apadrinamientos? Are you licensed with any group, association or society relating to the job for which you are applying? Yes No Tiene licencia de algún grupo, asociación o sociedad relacionada con el trabajo que está solicitando? Sí No Registration or License Number Número de inscripción o licencia State Issued Estado que la expidió Expiration Date Fecha de vencimiento Equipment Operation check any on the list below that you can operate, how many years do you have operating the checked ones, list any known model/type used Operación de maquinaria marque cualquiera de la lista que pueda operar; años que lleve operando lo marcado; indique todo modo/tipo conocido usado Trencher: Dump Truck Excavadora: Camión volcadora: Backhoe: Welder: Retroexcavadora: Soldadora: Bulldozer: Shop Machinery: Topadora: Maquinaria de taller: Loader: Fusing Equipment: Cargadora: Equipo de fusión: Boom Truck: Directional Drill Camión grúa: Perforadora direccional: Mini Excavator Side Boom: Miniexcavadora: Grúa lateral: Employment References Referencias laborales List individuals familiar with your job qualifications (no relatives or personal friends). Indique personas familiarizadas con sus calificaciones laborales (no incluir parientes ni amigos personales). Name: Nombre: Dirección de correo electrónico: Relationship: Relación: How long known? Cuánto tiempo hace que se conocen?
4 Name: Nombre: Dirección de correo electrónico: Relationship: Relación: Name: Nombre: Relationship: Relación: How long known? Cuánto tiempo hace que se conocen? Dirección de correo electrónico: How long known? Cuánto tiempo hace que se conocen? Employment History (start with most recent; use separate sheet if necessary) Antecedentes de empleo (comience con el más reciente; use una hoja aparte de ser necesario) Name of Employer: Nombre del empleador: Job Title: Puesto laboral: Name of Immediate Supervisor: Nombre del supervisor inmediato: Description of Duties: Descripción de las obligaciones: Employment Dates (month and year) From: Fechas de empleo (mes y año) De A: To: Pay (start): Paga (inicio): Pay (end): Paga (fin): Reason for Leaving: Razón por la que se fue: If currently employed, may we contact as a reference? Yes No Si trabaja en la actualidad, podemos comunicarnos como referencia? Sí No Name of Employer: Nombre del empleador: Job Title: Puesto laboral: Name of Immediate Supervisor: Nombre del supervisor inmediato: Description of Duties: Descripción de las obligaciones: Pay (start): Paga (inicio): Pay (end): Paga (fin): Employment Dates (month and year) From: Fechas de empleo (mes y año) De A: Reason for Leaving: Razón por la que se fue: To:
5 Name of Employer: Nombre del empleador: Job Title: Puesto laboral: Name of Immediate Supervisor: Nombre del supervisor inmediato: Description of Duties: Descripción de las obligaciones: Pay (start): Paga (inicio): Name of Employer: Nombre del empleador: Job Title: Puesto laboral: Name of Immediate Supervisor: Nombre del supervisor inmediato: Description of Duties: Descripción de las obligaciones: Pay (end): Paga (fin): Employment Dates (month and year) From: Fechas de empleo (mes y año) De A: Reason for Leaving: Razón por la que se fue: Employment Dates (month and year) From: Fechas de empleo (mes y año) De A: To: To: Pay (start): Paga (inicio): Pay (end): Paga (fin): Reason for Leaving: Razón por la que se fue: Relevant Experience (please list any other relevant experience you may have) Experiencia pertinente (indique toda otra experiencia pertinente que tenga)
6 Please Read Carefully Before Signing This Form Lea con detenimiento antes de firmar este formulario 1. All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired. Toda la información incluida en esta solicitud es correcta y verdadera a mi leal saber y entender. Entiendo que las declaraciones falsas u omisiones de cualquier tipo pueden resultar en la denegación del empleo o ser la causa de despido subsiguiente si me contratan. 2. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with my employment background for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information about my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment. Autorizo a la compañía a investigar mis respuestas de esta solicitud y a comunicarse con todos y cada uno de mis empleadores anteriores o con cualquier persona que conozca mis antecedentes laborales a fin de verificar toda información que haya proporcionado y/o a fin de obtener cualquier información sobre mi empleo. Eximo y mantengo indemne completamente y a sabiendas a cualquier persona o empresa que proporcione información con respecto a mí y a mi empleo. 3. I understand that upon receiving a job offer, a physical examination and drug screening may be required. (Note: If this is a job requirement, you will be notified.) Entiendo que al recibir una oferta de empleo, puede ser obligatorio someterme a un examen físico y análisis de detección de drogas. (Nota: Si es una obligación del puesto, se le notificará.) 4. Regardless of whether or not I become employed by the company, I recognize this application is not and should not be considered a contract of employment. I understand that employment at the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company s, unless specifically provided otherwise in a written employment contract. I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms and conditions of employment other than an officer or official of the company, and then only by means of a signed, written document. Independientemente de que la compañía me emplee o no, reconozco que esta solicitud no es ni será considerada un contrato de empleo. Entiendo que el empleo en esta compañía es voluntario y que mi empleo puede cesar con o sin causa, y sin notificación previa, en cualquier momento, a opción mía o de la compañía, a menos que se indique específicamente lo contrario en un contrato de empleo escrito. También entiendo que ningún empleado o representante de la compañía tiene la autoridad de celebrar un contrato con respecto a la duración o términos y condiciones de empleo excepto un funcionario o ejecutivo de la compañía y solo por medio de un documento escrito firmado. Signed by Firmado por Date Fecha Thank you for your interest in R.A.W Construction. Gracias por su interés en R.A.W Construction.
7 FIELD JOB GENERAL REQUIREMENTS REQUISITOS GENERALES PARA LOS TRABAJOS DE CAMPO NAME: NOMBRE DATE FECHA: 1. YOU MUST BE PHYSICALLY ABLE TO SAFELY LIFT AND CARRY TOOLS AND MATERIALS THAT COULD WEIGH AS MUCH AS 50 POUNDS AS PART OF A NORMAL JOB FUNCTION. DEBE SER FÍSICAMENTE CAPAZ DE LEVANTAR Y ACARREAR DE MODO SEGURO HERRAMIENTAS Y MATERIALES QUE PODRÍAN PESAR TANTO COMO 50 LIBRAS COMO PARTE DE UNA FUNCIÓN LABORAL NORMAL. 2. YOU MUST BE PHYSICALLY ABLE TO SAFELY USE AND/OR OPERATE HAND DIGGING TOOLS AND/OR AIR OPERATED BREAKING/DIGGING EQUIPMENT AS PART AS A NORMAL JOB FUNCTION. DEBE SER FÍSICAMENTE CAPAZ DE USAR Y/U OPERAR DE MODO SEGURO HERRAMIENTAS DE PERFORACIÓN MANUAL Y/O EQUIPO NEUMÁTICO DE CONMUTACIÓN TÉRMINO/PERFORACIÓN COMO PARTE DE UNA FUNCIÓN LABORAL NORMAL. 3. YOU MUST BE ABLE TO MOVE/PERFORM AT AN ACCELERATED PACE AS A PART OF A NORMAL JOB FUNCTION. DEBE SER CAPAZ DE MOVERSE/DESEMPEÑARSE A UN RITMO ACEPTABLE COMO PARTE DE UNA FUNCIÓN LABORAL NORMAL. 4. YOU MUST BE ABLE TO MOVE/PERFORM NORMAL JOB FUNCTIONS WHILE EXPOSED TO INCLEMENT OR EXTREME WEATHER CONDITIONS AND TEMPERATURES. DEBE PODER MOVERSE/DESEMPEÑAR FUNCIONES LABORALES NORMALES MIENTRAS SE EXPONE A CONDICIONES CLIMÁTICAS Y TEMPERATURAS EXTREMAS O INCLEMENTES. 5. YOU MUST BE ABLE TO ENTER AND EXIT OSHA SAFE EXCAVATIONS AS REQUIRED AS A NORMAL JOB FUNCTION. DEBE PODER INGRESAR Y SALIR DE EXCAVACIONES SEGURAS DE ACUERDO CON LAS NORMAS OSHA SEGÚN LO REQUERIDO POR LA FUNCIÓN LABORAL NORMAL. 6. YOU MUST BE ABLE TO STAND FOR LONG PERIODS OF TIME WITHOUT DISCOMFORT OR ASSISTANCE IF A JOB FUNCTION REQUIRES IT. DEBE SER CAPAZ DE ESTAR DE PIE POR LARGOS PERÍODOS SIN INCOMODIDAD NI ASISTENCIA SI SU FUNCIÓN LABORAL LO REQUIERE. 7. YOU MUST BE ABLE TO SQUAT, TURN, TWIST, PUSH, AND PULL ALL OF WHICH ARE SPECIFIC REQUIREMENTS OF THE JOB. DEBE SER CAPAZ DE AGACHARSE, GIRAR, DOBLARSE, EMPUJAR Y JALAR, TODOS LOS CUALES SON REQUISITOS ESPECÍFICOS DE ESTE TRABAJO. 8. YOU MUST BE ABLE TO BEND AT THE WAIST AND PERFORM PHYSICAL JOB FUNCTIONS WITHOUT DISCOMFORT OR PAIN AS PART OF A NORMAL JOB FUNCTIONS AND REQUIRMENTS. DEBE SER CAPAZ DE INCLINARSE DESDE LA CINTURA Y DESEMPEÑAR FUNCIONES LABORALES FÍSICAS SIN INCOMODIDAD O DOLOR COMO PARTE DE LOS REQUISITOS Y DE LA FUNCIÓN LABORAL NORMAL. 9. YOU MUST BE ABLE TO WEAR PERSONAL PROTECTIVE EQUIPMENT WHEN THE JOB REQUIRES IT. DEBE SER CAPAZ DE USAR EQUIPO DE PROTECCIÓN PERSONAL CUANDO EL TRABAJO LO REQUIERA. 10. YOU UNDERSTAND THAT FOR YOUR PERSONAL SAFTEY AND THE SAFETY OF THOSE AROUND YOU, ALL PRESCRIPTION MEDICATION THAT COULD CAUSE DIZZINESS, DROWSINESS, OR ANY OTHER PHYSICAL IMPAIRMENT MUST BE REPORTED TO MANAGEMENT BEFORE REPORTING TO YOUR WORK ASSIGNMENT. ENTIENDE QUE POR SU SEGURIDAD PERSONAL Y LA SEGURIDAD DE LOS QUE LO RODEAN, TODO MEDICAMENTO RECETADO QUE PUDIERA CAUSAR MAREO, ADORMECIMIENTO O CUALQUIER OTRO TIPO DE DIFICULTAD FÍSICA DEBE SER INFORMADO A LA GERENCIA ANTES DE PRESENTARSE A SU ASIGNACIÓN LABORAL.
8 11. YOU MUST BE ABLE TO HAVE THE ABILITY TO WALK AND FUNCTION ON JOBSITES WHERE THE TERRAIN IS SOFT, SLIPPERY, SLOPED OR UNEVEN WITHOUT DIFFICULTY. DEBE SER CAPAZ DE CAMINAR Y FUNCIONAR SIN DIFICULTAD EN SITIOS DE TRABAJO DONDE EL TERRENO SEA BLANDO, RESBALOSO, INCLINADO O DESPAREJO. IF YOU WISH TO EXPLAIN FULLY ANY REASON YOU WOULD NOT BE ABLE TO PERFORM THE DUTIES ABOVE, PLEASE DO SO BELOW AND INDICATE THE NUMBER OF THE REQUIREMENT. SI DESEA EXPLICAR POR COMPLETO CUALQUIER RAZÓN POR LA QUE NO PODRÍA DESEMPEÑAR LAS TAREAS INDICADAS ARRIBA, HÁGALO ABAJO E INDIQUE EL NÚMERO DEL REQUISITO I have received a copy of the job description and upon review I acknowledge that I am: He recibido una copia de la descripción del puesto de trabajo y, después de revisarla, reconozco que: Able to perform the essential job duties as outlined above. Puedo desempeñar las tareas laborales esenciales indicadas arriba NOT able to perform the essential job duties as outlined above without accommodation. NO puedo desempeñar las tareas laborales esenciales indicadas arriba sin facilidades. Please explain your required accommodations: Explique las facilidades requeridas: NOT able to perform the essential job duties as outlined above even with accommodation. NO puedo desempeñar las tareas laborales esenciales indicadas arriba incluso con facilidades. Applicant s Signature: Firma del solicitante:
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