Employment Application
Please complete the entire application.
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Email *
1. Employer Information
Diplomat Construction & Demolition, Inc.
316 E Union Street
West Chester, Pennsylvania 19382
(484) 887-0853

It is the policy of Diplomat Construction & Demolition, 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.
2. Applicant Information
Applicant Full Name: *
Home Address: *
City/State/ZIP: *
Number of years at this address:
Daytime phone:
Evening phone:
Mobile phone: *
Social Security Number:
Driver's License (State/Number):
3. Emergency Contact
Who should be contacted if you are involved in an emergency?
Contact Name:
Relationship to you:
Address:
City/State/ZIP:
Daytime phone:
Evening phone:
4. Job Position Applied For:
Full or Part Time?
Clear selection
What is your current rate of pay? *
What is your expected rate of pay? *
5. Are you at least 18 years old?
Clear selection
7. Are you willing to work any shift, including nights and weekends?
If no, please state any limitations:
8. If applicable, are you available to work overtime?
Clear selection
9. If you are offered employment, when would you be available to begin work?
10. If hired, are you able to submit proof that you are legally eligible for employment in the United States?
Clear selection
11. Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation?
Clear selection
What reasonable accommodation, if any, would you request?
12. Applicant's Skills
List any skills that may be useful for the job you are seeking. Enter the number of years of experience, and circle the number which corresponds to your ability for each particular skill. (One represents poor ability, while five represents exceptional ability.)
Do you have a current OSHA 10 certification? *
Skill:
Years of Experience:
Ability/Rating
Skill:
Years of Experience:
Ability/Rating
Skill:
Years of Experience:
Ability/Rating
13. Application Employment History:
List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment.  If you have no previous employment, please write "None" under "Employer Name".
May we contact your previous employers? *
Employer Name: *
Supervisor Name:
Address:
City/State/ZIP:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
Employer Name:
Supervisor Name:
Address:
City/State/ZIP:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
Employer Name:
Supervisor Name:
Address:
City/State/ZIP:
Job Duties:
Reason for Leaving:
Dates of Employment (Month/Year):
College/University Name and Address:
Did you receive a degree?
Clear selection
If yes, degree(s) received:
High School/GED Name and Address:
Did you receive a degree?
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Other Training (graduate, technical, vocational):
Please indicate any current professional licenses or certifications that you hold:
Awards, Honors, Special Achievements:
Military Service:
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Branch:
Specialized Training:
15. References
List any two non-relatives who would be willing to provide a reference for you.
Name:
Address:
City/State/ZIP:
Telephone:
Relationship:
Name:
Address:
City/State/ZIP:
Telephone:
Relationship:
16. Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer:
17. General Information
Valid Driver's License? *
Vehicle? *
Tools? *
If Yes, please list:
Construction Background? *
Steel Toe Boots? *
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