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Job Application Form

Please fill out the form as complete as possible. Human Resources will contact you
if we have a position that fits your background. Thank You.

We are an Equal Opportunity Employer, you have the option to print,
fill in and fax this pdf form. Fax: 920-337-9130

Equal Opportunity Form Holtger [8.16K]

*First Name:
*Last Name:
*Street Address:
*City:
*State:
Zip:
Phone or Cell:
Drivers License Number:
CDL:	Yes No
CDL Class:	A B C
List Moving Violations Last 5 years:
Education:
Position Applied For:
Expected Wages:
Who Referred You to HBI:
Date Available for Work:
Benefits you had at your last Job:	Dental Health Insurance Holiday Vacation Retirement Other
Last Employer Name, Address, Phone:
List Previous Employers Name, Address, Phone:
Dates of Employment:
Duties:
Reason for Leaving:
Who to Notify in Case of Emergency:
List Equipment Experience and Time:
Other Experience:
Companies Where You Gained the Experience:
Other Utilities You Have Worked For:
What Work Was Performed:
List Additional Skills That Relate to Position Desired:
List Employers You Do Not Want Contacted:

By submitting this application online you are agreeing to the following:

I hereby Declare the information provided by me in this application for employment is true, correct and complete to the best of my knowledge. I understand that, if employed, any misstatement or omission of fact on this application shall be considered cause for dismissal. I hereby authorize investigations of all statements contained herein and the references and employers listed above give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I hereby agree to submit to any lawful drug, or skills testing that may be required as a condition of employment or continued employment and understand that unless otherwise prohibited by law, refusal to submit to such testing during the course of employment may result in disciplinary action, up to and including discharge. As a condition of employment, I understand I am required to comply with HBI's drug-free workplace policy. I also understand that my employment is terminable-at-will, and that this application is not and is not intended to be contract for continued employment.

Holtger Bros., Inc. does not discriminate against any employee or applicant for employment, nor does Holtger Bros., Inc tolerate harassment of any kind because of race, religion national origin, sexual orientation, pregnancy, age, sex marital status, handicap, veteran status or other factors identified and protected by law. this policy applies to recruitment, selection placement, compensation, benefits, training, transfer, promotion, leaves of absence, demotion, termination and any other employment related procedures.