Employment Application Step 1 of 6 16% PERSONAL CONTACT INFORMATIONFull Name* First Middle Last Mailing 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 Physical Address* Same as previous 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 Home Phone*Mobile PhoneEmail Address* Social Security Number* Date of Birth* DD slash MM slash YYYY Biological Gender*Select OneMaleFemaleI'd Rather Not SayReferred By Emergency Contact* Emergency Contact Number* DESIRED POSITION & GENERAL INFORMATIONWhat Position Are You Applying For?*Select OneForeman or ManagerGeneral LaborerWhat Type Of Position Are You Applying For?*Select OneAny Available (Full-Time)Any Available (Part-Time)Full-Time PerminentFull-Time TemporaryPart-Time PerminentPart-Time TemporaryFirst Shift - 7:30 am - 4:00 pm (M-F)Are You Willing To Consider Other Available Positions?* Yes No I would Consider It We May Have Positions Available in New Stanton or Philadelphia, PA with one of our partner companies. (Proscape, LLC, Site Ready Construction, LLC or Stabilized Earth Solutions, LLC)When Would You Be Available To Start Working?* DD slash MM slash YYYY Are You Currently Employed?* Yes No N/A May We Contact Your Current Employer?* Yes No N/A Have You Ever Applied to Work For Us Before?* Yes No Including Proscape, LLC, Site Ready Construction, LLC and Stabilized Earth Solutions, LLC.If So, When? DD slash MM slash YYYY Do You Have Friends or Family Currently Employed With US?* Yes No If So, Who? Have You Served In The US Military?*Select OneYes, Honorably DischargedYes, But Not Honorably DischargedNo, I have Never ServedHave You Ever Been Convicted of A Felony?*Select OneNoYesI would rather explain in personDo You Have Any Medical Conditions That Limit Your Ability to Stand for Prolonged Periods or Conduct Repetitious Movments.*Select OneNoYesIf Yes, Please Explain.Do You Have Any Conditions that Would Prevent You From Lifting, Moving or Stacking Boxes (50 - 120 Lbs).*Select OneNoYesIf Yes, Please Explain.Do You Have Any Special Skills or Training? My Education & TrainingWhat is Your Highest Level of Education?*Select OneGEDHigh School DiplomaTechnical School GraduateSome College (No Degree)Technical College GraduateAS or BS College DegreePost Graduate DegreeWhat is the Name of the High School you Attended?* Did You Graduate from this High School?* Yes No I Earned My GED Address of High School* 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 High School From Date* DD slash MM slash YYYY High School To Date* DD slash MM slash YYYY Where did you Attend Trade School? (If Any) Did You Graduate this Trade School? Yes No Address of Trade School 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 Trade School From Date DD slash MM slash YYYY Trade Shchool To Date DD slash MM slash YYYY Where Did You Attend College? (If Any) What is the Address of the College? 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 College From Date MM slash DD slash YYYY College To Date DD slash MM slash YYYY Do You Have Any Additional Training or Certifications? Quiz: Please Answer The Following Questions:You have a 48' long, 8'6" wide flat bed trailer that can haul 46,500 lbs. You have 26 full pallets (48"x 48") of block that have to be shipped out this morning with a combined total weight of approximately 46,250 lbs. How many Pallets would you load onto the Semi-Truck?*Select One26 Pallets24 Pallets23 Pallets22 PalletsA 48' long, 8'6" wide flat bed trailer can haul 46,500 lbs. You have 26 full pallets (48"x 48") of block that have to be shipped out this morning weighing approximately 1,959 lbs each. How many Pallets would you load onto the semi-truck?Select One26 Pallets24 Pallets23 Pallets22 Pallets EMPLOYMENT HISTORYCurrent (or Last) Employer Current (or Last) Employers 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 Current (or Last) Employers PhoneYour Supervisor Your Position Started Working DD slash MM slash YYYY When Did You Leave? DD slash MM slash YYYY If No Longer EmployedReason You Left (or Reason You Desire to Leave)?Previous Employer Previous Employers 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 Previous Employers PhoneYour Supervisor Your Position Started Working DD slash MM slash YYYY When Did You Leave? DD slash MM slash YYYY If No Longer EmployedReason You Left (or Reason You Desire to Leave)?Previous Employer Previous Employers 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 Previous Employers PhoneYour Supervisor Your Position Started Working DD slash MM slash YYYY When Did You Leave? DD slash MM slash YYYY If No Longer EmployedReason You Left (or Reason You Desire to Leave)? PERSONAL REFERENCESName* Phone*How Do You Know This Person?* Name* Phone*How Do You Know This Person?* Name* Phone*How Do You Know This Person?* Consent* I Have Read & Agree To The Policy Shown BelowI certify that the facts contained in this application are true to the best of my knowledge and understand that any falsification, if employed, will result in dismissal. I authorize Mason's Mark Stone to contact any and all of my previous employers and release Mason's Mark Stone from any liability that may result from such information.Upload Any Requested Documentation Drop files here or Select files Accepted file types: pdf, jpg, png, gif, Max. file size: 50 MB. CommentsThis field is for validation purposes and should be left unchanged. Δ