Safety Record: List all accidents for the past 5 years. Please describe.
Specialized Skills: (heavy equipment operator, mechanical maintenance, construction, forklift, etc.)
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I certify that I have read and understood the employment application, and I am submitting this application for the sole purpose of seeking employment with Fischer Concrete Services. It is agreed and understood that Fischer Concrete Services or its agents may investigate my background and employment history, whether the same is of record or not. I understand that this information will be used for the purpose of determining my eligibility for employment with Fischer Concrete Services. I authorize, without reservation, any party or agency contacted by Fischer Concrete Services to furnish requested information concerning my work history and character. I release all employers, USIS and other persons named herein from all liability for damages due to furnishing such information. I certify that this application was completed by me and all answers I have given are truthful to the best of my knowledge. I understand that any misrepresentations or omissions may result in my rejection for consideration or dismissal. I agree to furnish additional information and complete examinations, and drug and alcohol tests as may be required.
I agree to reimburse Fischer Concrete Services the total cost of my pre-employment drug screening if one of the following should occur: