Job Application

- Step 1 of 13

Thank you for your interest in a career with W-S Companies. We are looking forward to the opportunity to review your information.

What location are you applying for? *

Date of Application *

Position Applied For *

How did you hear about this position?

If you were referred to this position, please provide the name of the person who referred you.

Have you ever applied to or worked for W-S Companies before?

What position and location?

What is your email address? *

Upload your resume.

Click or drag a file to this area to upload.

Name *

First

Last

Social Security Number *

Telephone Number 1 *

Telephone Number 2

Emergency Contact

First

Last

Emergency Contact Telephone Number

List your physical home addresses for the prior seven years, including all states of residence.

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Prior Address 1

Address Line 1

Address Line 2

City

State

Zip Code

How long did you live there?

Prior Address 2

Address Line 1

Address Line 2

City

State

Zip Code

How long did you live there?

Are you at least 18 years of age? *

Desired Rate Of Pay

Enter the amount per hour only.

Are you currently employed?

How long since you left your last place of employment?

Referring to the description of job duties and responsibilities, do you think you are able to perform the essential functions of the job with or without reasonable accommodation?

Are you available to work different shifts?

Weekends and/or holidays?

Check the highest grade completed. *

College or Trade School

Name and city/state location of the last school attended: *

Have you ever been convicted of a crime besides simple traffic violations *

Explain the number of convictions, nature of offense leading to conviction, when the offense was committed, the sentence imposed, and type of rehabilitation (conviction of a crime will not necessarily be a bar to employment.

Mark all areas where you have received formal training or have experience:

Abrasive blasting
Electrical repair
Oxyacetylene cutting/welding
Air monitoring equipment
Explosive demolition
Permitted confined spaces
Chemical protective clothing
Forklift
Pneumatic tools
CMV driving/training
General automotive repair
Vacuum truck or air mover
Electric welding
OSHA/MSHA
Water blasting (10K psi or greater)

Other training or experience that you wish to describe

Driver License: Show driver licenses held in the last five years, including all licensing states

State *

License Number *

Class *

Expiration Date *

Endorsements *

State

License Number

Class

Expiration Date

Endorsements

State

License Number

Class

Expiration Date

Endorsements

Have you had any vehicle accidents in the last 3 years? *

Please provide the details.

Date of Accident 1

Nature of Accident 1 (Rollover, Head-on, etc.)

Were there any fatalities? (Accident 1)

Were there any injuries? (Accident 1)

Date of Accident 2

Were there any fatalities? (Accident 2)

Were there any injuries? (Accident 2)

Date of Accident 3

Nature of Accident 3 (Rollover, Head-on, etc.)

Were there any fatalities? (Accident 3)

Were there any injuries? (Accident 3)

Do you have any violations of motor vehicle laws (except parking) for which you have been convicted of or forfeited bond or collateral during the prior three years?

Location

Date

Charge

Penalty

Location

Date

Charge

Penalty

Location

Date

Charge

Penalty

Commercial Motor Vehicle Driving Experience:

Straight Truck

Type (van, flat, etc.)

Date From

Date To

Estimated Mileage

Tractor/semi-trailer

Type (van, flat, etc.)

Date From

Date To

Estimated Mileage

Other

Type (van, flat, etc.)

Date From

Date To

Estimated Mileage

Have you ever been denied a license, permit, or privilege to operate a vehicle? *

Has any license, permit, or privilege ever been suspended or revoked? *

Please explain

Are you applying for a driver position? *

Date of Birth

Have you tested positive or refused testing on a DOT drug or alcohol screen in the last three years? *

Please explain

Have you ever served in the US Armed Forces?

Which Branch?

Specialty

Induction Date

Discharge Date

Please upload a copy of your DD-214

Click or drag a file to this area to upload.

Show all employment for at least the prior five years. Driver applicants must show commercial driving-related employment within the last ten years. Show unemployment periods of more than 30 days. Furnish complete information. List in reverse order starting with the most recent employer. Add more pages as required.

Employer 1

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Employment Start Date

Starting Wage

Employment End Date

Ending Wage

Job Title/Position

Name of Last Supervisor

First

Last

Reason for Leaving

Did you drive a vehicle requiring a CDL?

Were you subject to the Federal Motor Carrier Safety Regulations while working at this job? (Interstate driver of CMV)

Was this job designated a safety-sensitive function in any DOT-regulated mode subject to alcohol and controlled substance testing requirements as required by 49 CFR part 40?

List job duties and responsibilities, skills used or learned, and advancements while working for this employer.

Employer 2

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Employment Start Date

Starting Wage

Employment End Date

Ending Wage

Job Title/Position

Name of Last Supervisor

First

Last

Reason for Leaving

Did you drive a vehicle requiring a CDL?

Were you subject to the Federal Motor Carrier Safety Regulations while working at this job? (Interstate driver of CMV)

Was this job designated a safety-sensitive function in any DOT-regulated mode subject to alcohol and controlled substance testing requirements as required by 49 CFR part 40?

List job duties and responsibilities, skills used or learned, and advancements while working for this employer.

Employer 3

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Employment Start Date

Starting Wage

Employment End Date

Ending Wage

Job Title/Position

Name of Last Supervisor

First

Last

Reason for Leaving

Did you drive a vehicle requiring a CDL?

Were you subject to the Federal Motor Carrier Safety Regulations while working at this job? (Interstate driver of CMV)

Was this job designated a safety-sensitive function in any DOT-regulated mode subject to alcohol and controlled substance testing requirements as required by 49 CFR part 40?

List job duties and responsibilities, skills used or learned, and advancements while working for this employer.

Employer 4

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Employment Start Date

Starting Wage

Employment End Date

Ending Wage

Job Title/Position

Name of Last Supervisor

First

Last

Reason for Leaving

Did you drive a vehicle requiring a CDL?

Were you subject to the Federal Motor Carrier Safety Regulations while working at this job? (Interstate driver of CMV)

Was this job designated a safety-sensitive function in any DOT-regulated mode subject to alcohol and controlled substance testing requirements as required by 49 CFR part 40?

List job duties and responsibilities, skills used or learned, and advancements while working for this employer.

Employer 5

Employer Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Employment Start Date

Starting Wage

Employment End Date

Ending Wage

Job Title/Position

Name of Last Supervisor

First

Last

Reason for Leaving

Did you drive a vehicle requiring a CDL?

Were you subject to the Federal Motor Carrier Safety Regulations while working at this job? (Interstate driver of CMV)

Was this job designated a safety-sensitive function in any DOT-regulated mode subject to alcohol and controlled substance testing requirements as required by 49 CFR part 40?

List job duties and responsibilities, skills used or learned, and advancements while working for this employer.

NOTICE TO DRIVER APPLICANTS

Drivers with Department of Transportation regulated employment during the prior three years have the following rights regarding the investigative information that will be obtained pursuant to 49 CFR Part 391.23 paragraphs (d) and (e):

The right to review the information provided by previous employers;
The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information;
The right to have a rebuttal statement attached to the alleged erroneous information if the previous employer and the driver cannot agree on the accuracy of the information.

APPLICATION FORM WAIVER

In exchange for the consideration of my job application by W-S Industrial Services, Inc., W-S Mechanical Group, LLC and/or W-S Specialty Services, LLC, hereinafter called “W-S,” I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other W-S practices, shall serve to create an actual or implied contract of employment or to confer any right to remain an employee of W-S, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned. That relationship cannot be altered except by a written instrument signed by the President of W-S. Both the undersigned and WS may end the employment relationship at any time, without specified notice or reason. If employed, I understand that W-S may unilaterally change or revise their benefits, policies, and procedures, and such changes may include a reduction in benefits.

I certify that I completed this application and that all entries and information in it are accurate, true, and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.

I also understand that:

W-S has a drug and alcohol policy that provides for pre-employment testing and testing after employment.
Consent to and compliance with such policy is a condition of my employment.
Continued employment is based on the successful passing of testing under such policy.

I further understand that continued employment may be based on the successful passing of job-related physical examinations.

Signature

Clear Signature

Date

Name

First

Last

Social Security Number

W-S is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, or disability. We assure you that your opportunity for employment with W-S depends solely on your qualifications. An employee’s employment with the Company is “at-will.” The Company may terminate the employment of any employee at any time at its sole discretion, with or without cause. Likewise, an employee may terminate his/her employment at any time at his/her sole discretion.

In consideration of any offer of employment or continued employment, I understand and acknowledge that as a condition of my contracted employment, I do hereby forever waive and release any claims I might have against the customers or clients of W-S Companies. This waiver shall include but is not limited to the officers, employees, and agents of the above-named entities.

I voluntarily give this waiver and release in recognition that any work-related injury that I might sustain while performing my duties on the premises or with equipment owned by the entities listed above is covered by state workers’ compensation statutes and is my sole remedy.

This waiver and release is further given to avoid circumvention of such state workers’ compensation statutes which may result from lawsuits my family or I might otherwise file against w-s companies, or their customers, clients, employees, or agents, based on the same injury or injuries.

Therefore, to the fullest extent allowed by law, I hereby waive and forever release any and all rights I have or might later have to make claims or bring suit against W-S Industrial Services Inc, their customers, and clients, or the officers, employees, and/or agents of all, based upon injuries which are covered under workers’ compensation statutes or such other similar laws pertaining to work-related injuries.

Name

First

Last

Signature

Clear Signature

Date

As part of our hiring background and investigation, we may obtain consumer reports to prepare an investigative consumer report. The investigative consumer report may consist of contacting all listed prior employers to verify your employment history. It may also include, but not be limited to, credit information reports, criminal history reports, and driving history records. Under the provisions of the Fair Credit Reporting Act (15 USC at 1681-1681u) as amended, we must have your written permission to obtain the information before we can seek such reports. You have the right, upon written request, to complete an accurate disclosure of the nature and scope of the investigation.

You are also entitled to a copy of your rights under the Fair Credit Reporting Act. In connection with my application for employment or continued employment at W-S Industrial Services and (or) affiliates (the Company), I understand that a consumer report and/or an investigative consumer report will be ordered that may include information as to my character, general reputation, personal characteristics, mode of living, work habits, performance, and experience, along with reasons for termination of past employment. I understand that to the extent permitted by applicable law, and as directed by company policy and consistent with the job described, the Company may be requesting information from public and private sources about me, including but not limited to social security number validation, criminal conviction records, employment, and earnings history, education, credit, licensing and certification checks, references, military service, sex offender registry, civil cases, OIG/GSA, OFAC/Patriot Act records, any sanctions list, FBI fingerprinting, and if applicable, workers’ compensation injuries, driving record, drug testing results.

I acknowledge that a telephonic facsimile (FAX) or photographic copy shall be as valid as the original. This release is valid for most federal, state, and county agencies. Suppose an agency or record source requires an alternative release form or additional identifying characteristics in order to release the requested information. In that case, I agree to provide the additional information and sign any additional release authorizations, if so requested by the Company. I acknowledge that under the provision of the Fair Credit Reporting Act, I am entitled to know if employment is denied because of information obtained by my prospective employer from a consumer report and/or investigative report.

I acknowledge that I may request a copy of any consumer report from the consumer reporting agency that compiled the report. I hereby authorize, without reservation, any reference, agency, institution, firm, school, employer, or other applicable record source contacted by the Company or its agent to furnish the information about me described in this release.

I hereby authorize the Company to obtain and prepare a consumer report and/or investigative consumer report as set forth above to investigate my employment application. I voluntarily provide my date of birth to obtain and verify records obtained in the background check. This authorization shall remain in effect throughout my employment. Reports may be ordered periodically during the course of my employment.

Signature

Clear Signature

Name

First

Last

Date

**** The Information Supplied Below Will Only Be Used To Request And Verify Records ****

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Maiden Name/Prior Name

First

Last

Social Security Number

Date of Birth

Driver's License Number

Driver's License State

Driver's License Expiration Date

If you are a current resident of CA, OK, MA, MN, NY, ME, WA, or NJ, you have the right to receive a copy of any consumer report pertaining to you that we obtain from a consumer reporting agency. If you would like a free copy of any report obtained or prepared, please check the box

Yes, I would like a free copy.

Job Application

Commercial Motor Vehicle Driving Experience:

Employer 1

Employer 2

Employer 3

Employer 4

Employer 5

NOTICE TO DRIVER APPLICANTS

APPLICATION FORM WAIVER

Business Hours

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