Job Application | Brazos Urethane, Inc.

Job Posting Title
Referral Source
Referring URL
Position Applied For*
Field Office Locations
Select one or more field offices you'd like to apply to
Date Available
Date Format: MM slash DD slash YYYY

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Applicant Information (Part I)
First Name*
Last Name*
Email*
Enter Email Confirm Email
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Social Security Number
Birth Date*
Date Format: MM slash DD slash YYYY

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Employment History (Job #1)
Employment history helps us determine your experience and wage determinations for Journeyman and Apprentice Level Positions. Please carefully and accurately list all relevant experience. All employment WILL BE verified.

If you do not have experience in Insulation/Roofing, that's okay! We are happy to train hard working, dedicated and motivated skilled workers.
Employer*
Phone*
Start Date*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: MM slash DD slash YYYY
Position Held*
Immediate Supervisor*
Phone*
May we contact for reference?*
- Yes
- No
Reason for Leaving*
Add Second Job?*
- Yes
- No

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Employment History (Job #2)
Employer*
Phone*
Start Date*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: MM slash DD slash YYYY
Position Held*
Immediate Supervisor*
Phone*
May we contact for reference?*
- Yes
- No
Reason for Leaving*
Add Third Job?*
- Yes
- No

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Education
What is the highest level of education you have completed?
Skills and Training
Specialty Skills - Check all that apply
Hold down the "CTRL" key on PC, or "⌘" key on Mac to make multiple selections
Other Skills and Experience
Please list any skills that you have or training you have completed that are relevant to the position you are applying for:
Comments and Closing Statement
Please add any comments, questions, or closing statements you'd like us to consider.

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E-Sign Consent & Acknowledgement*
- I Agree to use E-Sign
By Clicking "I Agree", I acknowledge that my "digital signatures" below will carry the same legal weight as a hand-written signature. E-Sign is offered as a convenience to you, the applicant. Paper applications are available in our office if you'd prefer.
Date*
Date Format: MM slash DD slash YYYY
Background Check, Workers Compensation Check Authorization
By signing below, I authorize Brazos Urethane, Inc. to perform a criminal history and background check as a consideration of my employment. I further authorize them to obtain a Workers Compensation History Report, which will include information about any claims I have filed on Worker’s Compensation.
Signature*
E-Verify Authorization
By signing below, I authorize Brazos Urethane, Inc. to verify my eligibility to work in the United States through E-Verify.
Signature*
Release of Motor Vehicle Records
I authorize Brazos Urethane, Inc. to obtain copies of my Motor Vehicle Records from any state wherein I am or have been a licensed driver at any time. I understand that these records will be used to determine my eligibility for employment, either to be hired, or to continue employment with Brazos Urethane, Inc. Any information contained in this Motor Vehicle Record may be revealed to any persons that may have good cause to need this information. Management of Brazos Urethane, Inc. will have sole authority without recourse to determine the acceptability of any information contained in my Motor Vehicle Record. I have been given an opportunity to ask questions, and have received clarification and fully understand the implications of this authorization. Brazos Urethane, Inc. has not liability for any action taken due to information contained on said Motor Vehicle Record should such information be in error.
Signature*
Drug Test Consent
I have applied for employment with Brazos Urethane, Inc. I understand that as a condition for my being considered for employment, I may be required to undergo drug and/or alcohol testing. I willingly agree to this testing and understand that if my test results are positive, I shall not be considered further by Brazos Urethane, Inc. for this position.
Signature*

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Acknowledgement & Submission
I certify that I have read and understood all of this employment application. It is agreed that Brazos Urethane, Inc. or agents of said company may investigate my background to ascertain any and all information of concern to my criminal history and employment history, whether same is of record or not, and I release employers and other persons named herein from all liability for any damages on account of furnishing such information.

I understand as an applicant for a position with Brazos Urethane, Inc., I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the result of a physical examination and/or drug test. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with Brazos Urethane, Inc. and for no other reason.

It is also agreed and understood that under the Fair Credit and Reporting Act, Public Law 91-508, I am aware that this investigation may include an investigative Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living. I understand that misrepresentation or omission of information or facts may result in my rejection or dismissal.

I UNDERSTAND THAT THIS APPLICATION DOES NOT CREATE A CONTRACT OF EMPLOYMENT. I UNDERSTAND THAT, IF HIRED, I AM OBLIGATED TO COMPLY WITH ANY AND ALL CURRENT AND SUBSEQUENTLY ADOPTED BRAZOS URETHANE, INC. POLICIES AND THAT BRAZOS URETHANE, INC. DOES NOT OFFER CONTRACTS, PROMISES OR REPRESENTATIONS RELATED TO EMPLOYMENT. I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD OF TIME, AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF WAGES OR SALARY, BE TERMINATED AT ANY TIME FOR ANY REASON.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
Signature*
IP Address

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Step 1 of 8

Applicant Information (Part I)

Application Information (Part II)

Employment History (Job #1)

Employment History (Job #2)

Education

Skills and Training

Background Check, Workers Compensation Check Authorization

E-Verify Authorization

Release of Motor Vehicle Records

Drug Test Consent

Acknowledgement & Submission