Procon Employment Application

Name:*

First

Last

Address:*

Street Address City State / Province / Region Postal / Zip Code

E-mail:*

Phone:*

Area Code

-

Phone Number

Emergency Contact Name:

First

Last

Emergency Contact Phone:

Area Code

-

Phone Number

Employment Desired:*

Position Desired:*

Salary Desired: (If you were referred by a current employee, please list their full name)

Date you can start:*

Are you currently employed:*

Yes

No

If yes, where:*

May we inquire of your present employer?*

Yes

No

1/5

Complete only if you have a CDL.If you don't have one,click to jump to the Next page button.

Driving Experience

(Entry 01) Class of Equipment:

(Entry 01) Type of Equipment (van, tank, flat):

(Entry 01) Approximate number of miles (total):

(Entry 02) Class of Equipment:

(Entry 02) Type of Equipment (van, tank, flat):

(Entry 02) Approximate number of miles (total):

(Entry 03) Class of Equipment:

(Entry 03) Type of Equipment (van, tank, flat):

(Entry 03) Approximate number of miles (total):

(Entry 04) Class of Equipment:

(Entry 04) Type of Equipment (van, tank, flat):

(Entry 04) Approximate number of miles (total):

(Entry 05) Class of Equipment:

(Entry 05) Type of Equipment (van, tank, flat):

(Entry 05) Approximate number of miles (total):

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Yes

No

Has any license, permit, or privilege ever been suspended or revoked?

Yes

No

If yes to either of the above, please explain:

Accident record for past 3 years

(Entry 01) Date:

(Entry 01) Nature (head on, rear end, upset, etc):

(Entry 01) Fatalities or Injuries:

(Entry 02) Date:

(Entry 02) Nature (head on, rear end, upset, etc):

(Entry 02) Fatalities or Injuries:

(Entry 03) Date:

(Entry 03) Nature (head on, rear end, upset, etc):

(Entry 03) Fatalities or Injuries:

(Entry 04) Date:

(Entry 04) Nature (head on, rear end, upset, etc):

(Entry 04) Fatalities or Injuries:

(Entry 05) Date:

(Entry 05) Nature (head on, rear end, upset, etc):

(Entry 05) Fatalities or Injuries:

Traffic Convictions and Forfeitures for the past 3 years (other than parking violations)

(Entry 1) Location:

(Entry 1) Date:

(Entry 1) Charge:

(Entry 1) Penalty:

(Entry 2) Location:

(Entry 2) Date:

(Entry 2) Charge:

(Entry 2) Penalty:

(Entry 3) Location:

(Entry 3) Date:

(Entry 3) Charge:

(Entry 3) Penalty:

(Entry 4) Location:

(Entry 4) Date:

(Entry 4) Charge:

(Entry 4) Penalty:

(Entry 5) Location:

(Entry 5) Date:

(Entry 5) Charge:

(Entry 5) Penalty:

Employment records:
Note: DOT requires employment history for the past 10 years.

(Entry 1) Name of Employer:

(Entry 1) Name & Phone # of DOT/CDL administrator:

(Entry 2) Name of Employer:

(Entry 2) Name & Phone # of DOT/CDL administrator:

(Entry 3) Name of Employer:

(Entry 3) Name & Phone # of DOT/CDL administrator:

(Entry 4) Name of Employer:

(Entry 5) Name & Phone # of DOT/CDL administrator:

(Entry 4) Name & Phone # of DOT/CDL administrator:

(Entry 5) Name of Employer:

%47 - (Entry 02) Dates of Employment:%

5/5

I agree to submit to drug and alcohol testing. I release Procon, Inc., and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. Procon, Inc. is a drug free workplace.

Checkbox:*

I Agree

I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Procon, Inc creates an actual or implied contract of employment. I understand that, if I accept employment with Procon, Inc, it will be on an at-will basis. This means that either Procon, Inc or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.

Checkbox:(1)*

I Understand

I give permission for Procon, Inc. to get any information possible from references and previous employers and release the company from any liability that may result from utilization of such information.

agree to submit to drug and alcohol testing(1)(1)*

Yes

No

Any unsolicited application received by Procon will only be kept 30 days from the date of receipt.

Procon, Inc. is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability.

Procon, Inc does not accept partially complete applications, please fully complete this application before turning it in.

I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.

Signature of Applicant:*

Please retype this code in the blank field:

Education History

Employment History

CDL Portion

Complete only if you have a CDL.If you don't have one,click to jump to the Next page button.

Our Work

Projects

Westhall Industrial Shell

Steven Tanger Center For The Performing Arts

Fralin Biomedical Research Institute at VTC

Quirk Hotel

Pepsi Distribution Center

William B. Greene JR. Stadium

Nido & Mariana Qubein Arena and Conference Center

Project Unity

Egger Wood Products

Project Kodiak

Interchange cPad8

3TWENTY3

BB&T Point Baseball Stadium