Employment

Last Name *

Middle Name

First Name *

Address *

Home Phone *

Mobile Phone *

Email *

Date of Birth *

Nationality *

Bermudian

Spouse of Bermudian

Not Bermudian

If applicable please attach copy of Spouse’s Letter with application

Do you have a valid
driver’s license? *

Yes

Class

How did you become
aware of advert?

Royal Gazette

Workforce Development

Name of Employment Officer

Do you have experience
in the construction industry?

Yes No

If yes, please list skills

Are you currently employed? *

If so, where

EDUCATION

HIGH SCHOOL

Name and Location

Completion Date

COLLEGE OR UNIVERSITY

Name and Location

Completion Date

SPECIALIZED TRAINING, TRADE SCHOOL, ETC ...

Name and Location

Date Achieved

Please list your areas of highest proficiency, special skills or other qualifications that may contribute to your abilities in performing the above mentioned position.

PREVIOUS EMPLOYMENT

Dates Employed

Company Name

Location

Trade

Duties performed
and reason for leaving

Dates Employed

Company Name

Location

Trade

Duties performed
and reason for leaving

REFERENCES

Name

Contact Number

Name

Contact Number

Name

Contact Number

MEDICAL HISTORY

Have you any condition
of ill health or impediment,
which you should disclose
in the interest of good faith? *

Yes No

If yes, please give details:

LEGAL MATTERS

Have you ever been convicted
of a felony? *

Yes No

If yes, please give details:

DECLARATION

I declare that all the information I have given is true and I give D&J Construction Co., Ltd. the right to confirm my answers. I understand that any misrepresentation will cause cancellation of this application and severance from the company’s service if I have been engaged. I also understand that all appointments are subject to a three month probationary period and a satisfactory pre-employment medical which includes a screening for illegal substances. I know that D&J Construction Co., Ltd. has a drug and alcohol random testing policy for its management and employees and that, as a condition of my application being considered, I will submit a urine specimen to the company’s accredited testing agency. Any offer of employment will be withdrawn or probationary employment terminated if my specimen is tested positive for any illegal substance. I also authorize D&J Construction Co., Ltd. to check into my background as it relates to work history and police matters.

Applicant Signature *

Signature Date *

FOR OFFICE USE

Completed CURE Form

Yes No

Copy of driver’s license

Yes No

Drug Screened

Yes No

Cancel

Student Labourer	Labourer	Skilled Labourer
Jnr. Mason	Mason	Top Grade Mason
Steel Worker	Rebar	Mixerman
Finish Carpenter	Form Carpenter	Truck Driver INT
Heavy

Application for Employment

EDUCATION

HIGH SCHOOL

COLLEGE OR UNIVERSITY

SPECIALIZED TRAINING, TRADE SCHOOL, ETC ...

PREVIOUS EMPLOYMENT

REFERENCES

MEDICAL HISTORY

LEGAL MATTERS

DECLARATION

FOR OFFICE USE