Careers

Applicant Information

Full Name

Date

Address

City

State

ZIP Code

Phone

Email

Driver’s License

State Issued

Social Security

Position applying for

Date of Birth

Are you a citizen of the United States?YesNo

Have you ever worked for this company?YesNo

Have you ever been convicted of a felony?YesNo

Education

High School

Address

College

Address

Other

Address

References

Please list three professional references.

Employment History

Emergency Contact

Who should be contacted if you are involved in an emergency?

Contact Name

Relationship to you

Phone

Address

Name of Doctor

Allergies, Medication, etc.

Military Service

Military Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature

Date

Authorization of Background Check

Please read and sign this form in the space provided below. Your written authorization is necessary for Double M Operations, LLC to commence work on certain construction sites.

Name

Current Address

Social Security

Date of Birth

Driver’s License

State of Issue

In connection with my employment at Double Operations, LLC, I hereby authorize Double M Operations, LLC to conduct a security background check on me. I understand that this security check will cover information such as criminal history. Double M Operations, LLC is requesting your SS # and Date of birth to obtain accurate retrieval records and will not share this information with anyone outside the company. I hereby release Double M Operation, LLC and its employees from all liability resulting from the furnishing of this material. I certify that the statements made by me on this form are true and complete and correct to the best of my knowledge and are made in good faith. I understand that information collected from this investigation will not result in termination of my employment. You are entitled (at your request) to receive and review the collected information. A copy of this authorization and record will be held in your employment files.

Signature

Date