EmailMe Form - Carter Utility Tree Service

Name

First Last

Date Time

MM / DD / YYYY

Email

Social Security Number

Contact Number

### - ### - ####

Mailing Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Street Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Are you Employed Now?

Yes

No

Are You 18 Years of Agae or Older?

Yes

No

May We Talk With Your Present Employer?

Yes

No

Do You Possess a Valid Driver's License

Yes

No

Position Applies For:

Date You Can Start Work?

MM / DD / YYYY

Salary Desired?

Have You Applied for a Position With, or Ever Worked for CUTS Before?

Yes

No

If Employed ... When and Why Did You Leave CUTS

Have You Been Convicted of Any Criminal Offense (in the past 10 years)?

Yes

No

If So ... When and Provide Basic Details

Does Your VISA or Immigration Status Prevent you From Being Lawfully Employed in the United States?

Yes

No

Employment with this company is contingent upon the successful completion of a drug screening test to be administered after an offer or employment has been made. Successful completion of the test means that the applicant has tested negative for illegal drugs or substances.

Grammar School Information

Grammar School Name

Did you Graduate?

Yes

No

Graduation Date

MM / DD / YYYY

Subjects Studied

High School Information

High School Name

Did you Graduate?

Yes

No

Graduation Date

MM / DD / YYYY

Subjects Studied

College Information

College Name

Did you Graduate?

Yes

No

Graduation Date

MM / DD / YYYY

Subjects Studied

Trade, Business, or Other Schooling Information

College Name

Did you Graduate?

Yes

No

Graduation Date

MM / DD / YYYY

Subjects Studied

General -- Do you possess any special skills, or are there other you'd like up to consider while reviewing your application? If so ... please describe below.

Past Service with Any Branch of the Military?

Yes

No

Branch?

Rank?

Present Membership in Guard or Reserves?

Yes

No

Honorable Discharge?

Yes

No

Former Employers

(List Your Last Four Employers ... Including Your Ending Salary, Position & Reason for Leaving

Former Employer #1
Date Started

MM / DD / YYYY

Former Employer #1
Date Left Job

MM / DD / YYYY

Name of Employer #1

Salary Employer #1

Position Employer #1

Reason for Leaving Employer #1

Former Employers #2

Former Employer #2
Date Started

MM / DD / YYYY

Former Employer #2
Date Left Job

MM / DD / YYYY

Name of Employer #2

Salary Employer #2

Position Employer #2

Reason for Leaving Employer #2

Former Employers #3

Former Employer #3
Date Started

MM / DD / YYYY

Former Employer #3
Date Left Job

MM / DD / YYYY

Name of Employer #3

Salary Employer #3

Position Employer #3

Reason for Leaving Employer #3

Former Employers #4

Former Employer #4
Date Started

MM / DD / YYYY

Former Employer #4
Date Left Job

MM / DD / YYYY

Name of Employer #4

Salary Employer #4

Position Employer #3

Reason for Leaving Employer #3

Former Employers #4

Which of These Jobs Did You Like Best?

What Did You Like Most About This Job?

REFERENCES:

Give the Name of Three Persons Not Related to You, Whom You Have Known at Least One Year.

1. Reference Name #1

First Last

Reference Address #1

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Reference Contact Number #1

### - ### - ####

Years Aquainted

REFERENCE #2

1. Reference Name #2

First Last

Reference Address #2

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Reference Contact Number #2

### - ### - ####

Years Aquainted

REFERENCE #3

1. Reference Name #3

First Last

Reference Address #3

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Reference Contact Number #3

### - ### - ####

Years Aquainted

In Case of Emergency Please Notify Either:

Emergency Contact Name #1

First Last

Emergency Contact Work Number #1

### - ### - ####

Emergency Contact Home Number #1

### - ### - ####

Emergency Contact Cell Number #1

### - ### - ####

Emergency Contact Name #1

First Last

Emergency Contact Work Number #1

### - ### - ####

Emergency Contact Home Number #1

### - ### - ####

Emergency Contact Cell Number #1

### - ### - ####

The next section is the "Pre-Employment Questionnaire" the asks a series of questions that should each be answered with a simple "YES" or "NO" response. The questionnaire must be completed, in order for your applicaton to be considered.

Are you at least 18 years of age?
You MUST be at least 18 years of age to be considered for employment with CUTS, Inc.

Yes

No

Do you have a valid, state issues driver's license?
You MUST have a valid, state issued driver's license to be considered for employment with CUTS, Inc.

Yes

No

Have you been convicted of violating any motor vehicle laws in the past 7 years?
You MUST provide accurate details (including dates) of any and all such violations on the comments section.

Yes

No

Do you have a valid class "A" or "B" Commercial Driver's License (with air brake endorsement)?

Yes

No

Do you have reliable transportation to get you to and from work?

Yes

No

Are there any circumstances or issues that might prevent you from being at work every scheduled workday?

Yes

No

If so, why.

Have you worked with a utility right-of-way maintenance or tree company working around live electrical lines?

Yes

No

Are you or have you ever been certified as a "Line Clearance Tree Trimmer" or as a Class "A" or "B" Climber?

Yes

No

Do you have experience working with heavy equipment? (Bulldozers, skidders, track loaders, commercial tractors, etc.)

Yes

No

Do you have experience running a disc-type tree chipper?

Yes

No

Do you have extensive experience using a chainsaw?

Yes

No

Do you have any practical mechanics experience?

Yes

No

Do you have verifiable experience as a supervisor / foreman in any trade or service company?

Yes

No

Do you have a problem working in any of the counties that make up our customary service area? (Alleghany, Ashe, Forsyth, Stokes, Surry, Wilkes, Watauga, Yadkin, all North Carolina counties.)

Yes

No

I understand that the position with Carter Utility Tree Service, Inc. for which I am applying is a safety sensitive position ... that it is a position which is very physically demanding and that I will be expected to meet the physical demands of my employment. My duties will include, but are not limited to working extended hours in difficult weather conditions, working on steep and uneven terrain, climbing trees and removing limbs using various hand and power tools on a continuous basis during an eight to ten hour shift; removing and disposing of tree limbs using various mechanized pieces of equipment which can require lifted from 50 to 100 pounds. Be signing this application, I certify that I am both willing and physically able to perform these duties. By clicking that you understand, I am further certifying that all the information I have supplied on this application are true and complete and I understand that if any false information, omission or misrepresentation is discovered, my application my be rejected ... and if such is discovered at any time after I am employed, my employment may be terminated. I also acknowledge that in consideration of my employment, I agree to conform to all company policies, rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I further understand that no company representative, other than the company president, (and then only when in writing and signed by the president), has any authority to enter into any agreement concerning employment for any specific period of time, or to make any agreement of any kind contrary to any of the foregoing.

Do you understand and agree to the terms listed above?

Yes, I understand that I have fully read, understand and agree to all provisions and conditions of this application

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