DMJ Employment Application

An Equal Opportunity Employer

Name: ______________________________________________________

Address: _____________________________________________________

City: ___________________________________ Zip: _________________

Phone: _____________________ Alt. Phone: _______________________

Social Security Number: ________________________________________

Drivers License Number: __________________________ State: _________

License Class: A (  )  B (  )  C (  )  D (  )  (please check one)

Violations in past 5 years: Yes (  )  No (  )  (please check one)

If yes, please briefly explain: ______________________________________

____________________________________________________________

Employment History (List most recent first)
Dates of Employment
Company Name
& Phone Number
Position Held

From: __________

To: __________

    

From: __________

To: __________

    

Equipment Experience:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

 

Any other comments you would like to add:

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

Please complete and send to:
DMJ Asphalt Inc.
2392 Pioneer Trail
Hamel, MN 55340-0299