Apply for Field Welder/Pipe and Mechanical Installer

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Summary
Title:	Field Welder/Pipe and Mechanical Installer
ID:	1106
Department:	Operations
Salary Range:	$28-$37/hour based on experience
Benefits:	100% Employer paid premiums for health, dental, short-term disability, and long-term disability insurance. Paid time off plan. Other benefits include education reimbursement, paid company training, and profit sharing bonuses.
Retirement Benefits:	Average retirement plan contributions of 20-22% of eligible earnings into Employee Stock Ownership Plan and 401K Plan.
Contact Information
* First Name:
* Last Name:
* Middle Initial:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
Mobile Phone:
* Email:
Attachments
Resume:	Supported formats: Word, PDF, RTF, Text, and HTML.

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Cover Letter:	You can type in a Cover Letter or Copy/Paste from an existing document.

Employment Questionnaire

* Can you occasionally lift 100# ?

	Yes
	No

* Can you climb and work to 30' heights?

	Yes
	No

* Can you do strenuous work for at least 10 hours?

	Yes
	No

* Are you able to travel 300 miles and stay overnight 3 to 4 nights per week

	Yes
	No

* High School Diploma or HSED

	Yes
	No

What is your post-secondary education and/or training?

	Associate Degree
	Bachelor Degree
	Journeyman
	Supervisor

* Where did you hear about us?

* Please specify what location? IE-what newspaper, employee, etc

Pipe and Mechanical Installer Questionaire

Check each line yes or no

* Do you have a steamfitter, millwright or plumber journeyman card?

	Yes
	No

* Have you started but not yet completed an apprenticeship program in the trades above?

	Yes
	No

* Do you have OSHA 10 training?

	Yes
	No

* Are you a trained competent person for trenching and excavating?

	Yes
	No

* Do you have 2 years experience in trenching, excavating and dewatering techniques?

	Yes
	No

* Do you have at least 3 years experience changing out/installing industrial pumps, valves, electrical controls or other mechanical equipment?

	Yes
	No

* Do you have metal fabrication skills and experience?

	Yes
	No

* Do you have water/wastewater installation/maintenance experience?

	Yes
	No

* Do you have experience working for an underground utility firm or organization?

	Yes
	No

Application for Employment

PERSONAL INFORMATION

* Are you at least 18 years or older?:

Yes No

* When would you be available to begin work?:

* Hourly rate/salary desired:

* Have you ever applied to this company before?:

Yes No

EMPLOYMENT DESIRED

* Are you currently employed?:

Yes No

If so may we inquire of your present employer?:

Yes No

If presently employed, why are you considering leaving?:

How did you hear about us?:

Newspaper Referral Website

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location	Did you Graduate?	Degree Received	Subjects Studied/Major
	Yes No
	Yes No
	Yes No

If you have completed any special courses, seminars, apprenticeships and/or training that would help you to perform the position for which you are applying, please describe:

EMPLOYMENT HISTORY

Give your full employment record, starting with your current or most recent employment

EMPLOYER 1

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 2

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 3

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

EMPLOYER 4

Dates Employed	Employer Name & Address	Employer Phone
From: To:
Job Title	Supervisor Name & Title	May we Contact?
		Yes No
Responsibilities	Reason for Leaving	Salary/Hourly Rate
		Start: End:

WORK REFERENCES Please provide three references not related to you, whom you worked with for at least one year.

Name	Relationship	Phone Number	Email
*	*	*	*

AUTHORIZATION, RELEASE AND CERTIFICATION I certify that the information in this application is true and understand that misrepresentations or false or omitted facts may result in my termination, regardless of the time of discovery by the company. I also understand that, if hired, my employment is for no definite period and may be terminated at any time without written notice and that, absent a written contract signed by the President of the company; I will remain an at will employee and can be terminated at any time without notice.
I authorize investigation of the statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information such references may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to you.
I understand that if I am offered employment with Staab Construction Corporation, I will be required to take a medical examination. I agree that if I begin working for Staab Construction Corporation prior to the receipt of the results of the medical examination by Staab Construction Corporation, I understand that Staab Construction Corporation may discharge me if the physical examination determines that I am unable to perform the essential functions of the job with reasonable accommodations.
I understand as a condition of employment, I shall be required to take a substance abuse test prior to the medical examination. If the result of the drug test is positive, Staab Construction Corporation shall withdraw the employment offer and I will not be allowed to reapply for a minimum of 30 days.
I understand that Staab Construction will obtain my motor vehicle report from the Wisconsin DOT upon hire.
I hereby certify that I have not executed any non-compete agreement, confidentiality agreement or other agreement that will prevent me from accepting employment with Staab Construction.

* Signature (type name):

* Date:

Voluntary Self-Identification of Disability CC-305

Voluntary Self-Identification of Disability

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Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

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