Contact Get in Touch with Us in Utah Contact Information 9489 S. 6400 W.West Jordan, UT 84081 (801) 265-3797 [email protected] (801) 262-5319 Please Fill Out the Form Below Name* Phone*Email* Message Employment Application Name* First Middle Last Address Street Address City State / Province / Region ZIP / Postal Code Phone*Email Address* Are you 18 years of age or older? Yes No If required for position, do you have a valid driver's license? Yes No Are you eligible to work in the United States? Yes No Position Applying For EducationName of School Address City State / Province / Region Did You Graduate? Yes No Degree Received Other credentials/licenses/certifications which are relevant to the position for which you are applying. High School Address City State / Province / Region Did You Graduate? Yes No Degree Received Other credentials/licenses/certifications which are relevant to the position for which you are applying. GED Address City State / Province / Region Did You Graduate? Yes No Degree Received Other credentials/licenses/certifications which are relevant to the position for which you are applying. College Address City State / Province / Region Did You Graduate? Yes No Degree Received Other credentials/licenses/certifications which are relevant to the position for which you are applying. Other Address City State / Province / Region Did You Graduate? Yes No Degree Received Other credentials/licenses/certifications which are relevant to the position for which you are applying. SkillsPlease list technical skills, trade skills, clerical skills, and equipment experience that are relevant to the positionWork Experience Please detail your entire work history as it pertains to the position for which you are applying. Begin with your current or most recent employer. Please explain any gaps in employment. Attach addition sheets of necessary. PLEASE NOTE: Uinta Rock & Excavating reserves the right to contact all current and former employers for reference information.Dates EmployedFrom MM slash DD slash YYYY To MM slash DD slash YYYY TypeSelectFull TimePart TimeTitle Organization Name and AddressSupervisor's Name Supervisor's Phone NumberPrimary Duties Reason for Leaving Dates EmployedFrom MM slash DD slash YYYY To MM slash DD slash YYYY TypeSelectFull TimePart TimeTitle Organization Name and AddressSupervisor's Name Supervisor's Phone NumberPrimary Duties Reason for Leaving Dates EmployedFrom MM slash DD slash YYYY To MM slash DD slash YYYY TypeSelectFull TimePart TimeTitle Organization Name and AddressSupervisor's Name Supervisor's Phone NumberPrimary Duties Reason for Leaving The information in this application, my resume, and/or any supplemental information form is accurate, current, and complete. I understand that misstatements or omissions may result in disqualification from further consideration or termination of employment. I authorize Uinta Rock & Excavating and/or its agents to investigate my background, employment history and credentials, and to obtain any relevant information needed to make an employment decision. I agree to cooperate and assist in any such investigation, and I release Uinta Rock & Excavating and those supplying information to Uinta Rock & Excavating from liability with regard to use or disclosure of the information supplied.I also understand and agree that: Business needs may require as a condition of continued employment that I travel and/or work different shifts, positions, or overtime. Any employment is not for a fixed period of time and is terminable at the will of either Uinta Rock & Excavating or me, which means that either I or Uinta Rock & Excavating can terminate employment at any time with or without cause. No contrary representation or promises have been made to me and no such promise or representation shall be binding unless in writing and signed by an officer of Uinta Rock & Excavating.CAPTCHA
