Employment

It is the policy of VR Concrete, Inc. to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status. At VR Concrete, Inc. we believe that every employee helps to make us successful. We hope that you will be proud to be a member of our team. Benefits Include: Dollar for Dollar Matched Retirement Plan, Health Insurance, Paid Travel, Per Diem, Paid Holidays / Vacations and Competetive Wages.

First Name*

Last Name*

City*

State*

Zip

Phone Number*

Best Time to Contact You*

Email*

Emergency Contact

First Name Last Name Address City State Relation Day Time Number Evening Number

Employment Experience

List your current and most recent employment first.

May we contact employer 1? Yes No

Employer One Name

Address

Phone

Supervisor Name

Years with Employer 1

Work Duties

May we contact employer 2? Yes No

Employer Two Name

Address

Phone

Supervisor Name

Years with Employer 2

Work Duties

May we contact employer 3? Yes No

Employer Three Name?

Address

Phone

Supervisor Name

Years with Employer 3

Work Duties

Reference

Please provide at least 2 people who would be willing to provide a reference for you.

Reference 1

Reference 2

Reference 3

Please provide any other information that you believe should be considered.

I HAVE CAREFULLY READ THE BELOW CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.* Agree Disagree

CERTIFICATION

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize VR Concrete, Inc. to contact former employers and educational organization regarding my employment and education organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If any employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its President, the employment relationship will be entirely voluntary in nature. In other words, with appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer would have the same right. Moreover, no agent, representative, or employee of VR Concrete, Inc, except in a specific written contract of employment signed on behalf of the organization by its President, has the power to alter or vary the voluntary nature of the employment relationship.

Security