HR Form

Application for Employment

"*" indicates required fields

Application for Employment

INSTRUCTIONS

Wolverine Building Group ("WBG" or the "Company") abides by all federal, state, and local anti- discrimination law, regulations, and ordinances. The Company provides and promotes equal employment opportunities for all applicants and employees, and it trains, promotes, compensates, and administers all employment practices without regard to any protected characteristic. T he company is also committed to complying with the Americans With D isabilities Act (ADA) and any similar state or local laws or ordinances. If you believe that you have a disability and need a reasonable accommodation to apply for a job with WBG or to complete an application for employment, please notify the Human Resources Department at hr@wolvgroup.com or 616-949-3360 as soon as possible. The company may ask applicants or employees to provide documentation from the appropriate health care professional to confirm that the individual has a disability and to help assess possible reasonable accommodations, if any. When completing the application, be sure to answer all questions accurately and completely. Please do not provide information not requested. You must sign and date the application. If you do not comply with these instructions, your application will be disregarded.

TODAY'S DATE:*

TIME:*

Your Name*

First Middle Last

Current Address*

Street Address Address Line 2 City State ZIP Code

Length of time at this address:*

Your Phone*

Your Email Address

Job(s) Applied For:*

Rate of Pay Expected*

Per*

Job(s) Applied For:

Rate of Pay Expected

Per

Do You Want to Work:*

Additional Information

If applying for part-time, what days and hours?

Are you employed now?*

Yes

If yes, may we contact your employer?

Yes

Have you ever applied for work with us before?*

Yes

If yes, when?

List anyone you know who works for us:

Did anyone refer you?*

Yes

If yes, who referred you?

Construction Experience*

Describe the type of construction work you have done in the past

Do you have any skills, qualifications, or experiences which you feel would especially fit you for work with us?*

U.S. Armed Forces Service?*

Yes

From

Branch of Service

Duties:

Rank or rating at time of enlistment:

Rank or rating at time of discharge:

Were you dishonorably discharged?

Yes

If yes, explain:

Are you able to perform the essential functions of the job(s) for which you are applying, including but not limited to regular and reliable attendance?

Yes

If not, explain:

Do you have any activities, commitments, or responsibilities (for example carpooling, school, other employment) which might in any way restrict the hours (including overtime) or days you can work?

Are you 18 years of age or older?*

Yes

Have you ever been fired?*

Yes

If yes, why?

Have you ever been convicted of a crime (including a guilty or no contest plea)?*

Yes

If yes, explain when, where, and the nature of the offense

Are there any felony charges pending against you now?*

Yes

If yes, describe

Are you authorized to work in the United States?*

Yes

Do you have reliable means of transportation?*

Yes

If hired, when can you start?*

EDUCATION

Add your educational experience here. Add up to 3 locations in each category with + symbol.

High School

School Name

Number of Years Attended

City/State

Courses

Did you graduate?

Trade School/Other

School Name

Number of Years Attended

City/State

Courses

Did you graduate?

College

School Name

Number of Years Attended

City/State

Courses

Did you graduate?

PRIOR WORK EXPERIENCE

Please list your most recent employment first, use additional space below if necessary to list all prior employers. Add up to 6 with + symbol.

Name & Address of Employer

Dates

Type of Work Done

Starting Pay

Final Pay

Reasons for Leaving

BUSINESS REFERENCES

List only those persons who held managerial positions in the companies you were employed at during the time of your employment. Add up to 3 with + symbol.

Name

Address and Telephone No.

Occupation

APPLICANTS CERTIFICATION AND AGREEMENT

PLEASE READ CAREFULLY

Terms and Conditions*

1. Certification of Truthfulness.
I certify that all statements on this Application for Employment are complete and truthful and agree that such statements may be investigated and if found to be false will be sufficient reason for not being employed, or if employed may result in my dismissal.

2. Authorization for Employment/Educational Information.
I authorize the references listed in this Application for Employment, and any prior employer, educational institution, or any other persons or organizations to give this Company any and all information concerning my previous employment/educational accomplishments, disciplinary information or any other pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I hereby waive written notice that employment information is being provided by any person or organization.

3. Employment at Will.
If I am hired, in consideration of my employment, I agree to abide by the rules and policies of this Company, including any changes made from time to time, and agree that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I understand that no manager or other representative of the Company, other than the President, has any authority to enter into any agreement for employment for any specific or indefinite period of time, or to make any agreement contrary to the foregoing. Any such agreement made by the President must be made in writing to be effective.

4. Authorization to Work.
If I am selected for hire, I will be offered employment provided I verify that I am authorized to work as required by the Immigration Reform and Control Act of 1986.

5. Limitation on Claims.
I agree that any lawsuit or claim against the Company arising out of my employment or termination of employment (including but not limited to, claims arising under state, federal or local civil rights laws) must be brought within the following time limits or be forever barred: (a) for lawsuits requiring a Notice of Right to Sue from the EEOC, within 90 days after the EEOC issues that Notice; or (b) for all other lawsuits, within (i) 180 days of the event(s) giving rise to the claim, or (ii) the time limit specified by statute, whichever is shorter. I waive any statute of limitations that exceeds this time limit.

6. Need for Accommodation.
If I have a mental or physical disability and require an accommodation to perform the job, I must notify the Company of that need within 182 days after I knew or reasonably should have known that an accommodation was needed. Failure to do so will bar me from alleging that the Company has not accommodated me as required by law.

7. Criminal Records Check.
I authorize the Company to secure my criminal conviction history. I agree to execute the appropriate authorization if necessary to obtain such information.

8. Driving Record Check.
I agree to execute an authorization for this employer to inquire into, and obtain documents related
to, any driving record from every state in which I have held a motor vehicle operator’s license or permit.

9. Release of Medical Information.
I authorize every medical doctor, physician or other health care provider to provide any and all information, including but not limited to , all medical reports, laboratory reports, X-rays or clinical abstracts relating to my previous health history or employment in connection with any examination, consultation, test or evaluation. I hereby release every medical doctor, health care personnel and every other person, firm, officer, corporation, association, organization or institution which shall comply with the authorization or request made in this respect from any and all liability. I understand that this release will not be sent to my physician or other health care provider until a conditional job offer has been made.

10. Physical Exam and Drug and Alcohol Testing.
I agree to take a physical exam following a conditional job offer. I also authorize the Company or designated agent(s) to withdraw specimen(s) of my blood, urine, hair and/or other substances for chemical analysis. One purpose of this analysis is to determine or exclude the presence of alcohol, drugs or other substance. I understand that decisions concerning my employment may be made as a result of these tests.

11. Consideration for Employment.
I understand that my application will be considered pursuant to the Company’s normal procedures for a period of thirty (30) days. If I an still interested in employment thereafter, I must reapply.
I agree that if any of the above commitments is ever found to be legally unenforceable as written,
the particular commitment concerned shall be limited to allow its enforcement as far as legally possible.
I have read, understand, and agree to items 1 through 11 above. I knowingly and voluntarily acknowledge that with my signature below.

I have read and agree to the terms and conditions.

Applicant Signature*

Please type your full name as acknowledgement of applicants certification and agreement.

Dated:*

Todays Date