Application for EmploymentCOMPLETE THE FORM BELOW Personal InformationLocation(s) Applying For: *Jurupa Valley, CABakersfield, CAPhoenix, AZSan Diego, CASacramento, CAApplicant Name *Date *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone *Email Position Sought * *Full TimePart TimeDate Available *Salary Desired Driver's License # (If Applicable to Position) Are you over 18 years old? *YesNo (If offered employment, you will be required to provide documentation to verify eligibility.)Ethnicity American Indian/Alaskan NativeAsianBlackHispanicWhiteOtherIf Other, Please Specify Pavement Recycling Systems, Inc. is a committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Pavement Recycling Systems, Inc. provides a comprehensive benefits package for its employees and culture in which employees can grow and build their careers. Military ServiceAre you a veteran? *YesNoVietnam Veteran *YesNo Union *YesNoUnion Name Local # Union Job Classification Group Are you an apprentice? YesNo EducationHigh SchoolName *City State Years Completed *Diploma *YesNoG.E.D. YesNoCollegeName City State Major Years Completed Diploma YesNoVocational/OtherName City State Years Completed Graduate YesNo Previous EmploymentEmployer *Telephone Address (Street Address, City, State, Zip Code)Supervisor Job Title Job Duties Date Employment From To Full TimePart TimeReason For Leaving May we contact this employer? YesNoEmployer Telephone Address (Street Address, City, State, Zip Code)Supervisor Job Title Job Duties Employment From To Full TimePart TimeReason for Leaving May we contact this employer? YesNo Acknowledgment *I understand and acknowledge that unless otherwise defined by applicable law or written agreement with Pavement Recycling Systems, Inc. (PRSI), any employment with PRSI will be "employment at will". This means that I may resign at any time and PRSI may discharge me at any time, with or without cause, and with or without advance notice. All offers of employment are contingent on successfully passing a drug and background test. Pavement Recycling Systems, Inc. is an equal opportunity employer. We comply with the ADA and consider reasonable accommodations that may be necessary for eligible applications to perform essential functions. By clicking agree, you certify that your answers are true and complete to the best of your knowledge. If hired, you acknowledge that false or misleading information will result in release from employment.I AgreeUpload Resume Accepted Filetypes: PDF, DOC, DOCX, JPEG, PNG VerificationPlease enter any two digitsLeave this field blank.This box is for spam protection - please leave it blank:
