Family Owned and Operated Since 1974
Current Address:
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Mailing Address (if different from above):
Are you at least 18 years of age? YesNo
Have you been employed with MICHIE in the past? YesNo
Are you a US citizen or otherwise authorized to work in the US without restrictions?(NOTE: If offered a position, proof of eligibility will be required upon employment) YesNo
Have you ever been convicted of a crime in the last five (5) years that has not been annulled by a court? (Do not include misdemeanors or traffic violations). YesNo
If you have ever been convicted of a crime in the last five (5) years that has not been annulled by a court Do not include misdemeanors or traffic violations). Please explain.
Please list your present and past employment, beginning with your most recent employer. (You are not required to use all)
Start Date
End Date
Job Duties
Reason For Leaving (Be Specific)
Can we check references? YesNo
High School
Did you receive your diploma? YesNo
College or University
Did you receive your degree? YesNo
Trade School (Specify)
List your skills and any equipment you can operate:
Are you able to do the essential job functions of the position for which you have applied with or without reasonable accommodation?
Provide the information below for three (3) work references that are not related to you. If not applicable list three school or personal references that are not related to you.
Reference 1
Reference 2
Reference 3
Please read carefully before consenting and submitting application.
I certify that the information provided by me in this application and accompanying material is accurate and complete to the best of my knowledge. I understand that if I am employed by MICHIE CONCRETE PRODUCTS, LLC any misrepresentation or material omission made by me on this application or accompanying material may result in cancellation of this application or immediate discharge from the COMPANY, whenever it is discovered.
I hereby give MICHIE CONCRETE PRODUCTS, LLC the right to contact and obtain information from my references, employers, and educational institutions and to otherwise verify the accuracy of the information contained in this application. Further, I hereby release from liability MICHIE CORPORATION and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information and I release all of my previous employers and all their employees, representatives, officers, directors and agents from any claims arising out of, or in any way connected with, the disclosure to MICHIE CONCRETE PRODUCTS, LLC of information from my personnel files or any other information pertaining to my employment.
I understand that neither the acceptance of this application nor any employment relationship with MICHIE CONCRETE PRODUCTS, LLC creates an actual or implied contract of employment. If I am hired, I understand that my employment is at-will and that either MICHIE CONCRETE PRODUCTS, LLC or I may terminate my employment at any time for any lawful reason. This application does not constitute an agreement or contract for employment for any specified period or definite duration.
I understand that if I am hired by MICHIE CONCRETE PRODUCTS, LLC my offer of employment is subject to a pre-employment physical exam, successful completion of drug screening and satisfactory background check, which may include a motor vehicle records check.
I have read, or have had read to me, this section and fully understand these conditions as outlined above.
