Brannan Paving Company, LTD
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Note: A conviction will not necessarily result in denial of employment.

LIST BELOW ANY ACCIDENTS/TRAFFIC VIOLATIONS IN LAST 3 YEARS:

PREVIOUS EMPLOYMENT:

From To Employer Address/Location Kind of Work Reason for Leaving Supervisor Name & Number

It is the policy of Brannan Paving Co., Ltd. to provide equal employment opportunity to all employees and applicants for employment and not to discriminate on any basis prohibited by law, including race, color, sex, age, religion, national origin, disability, sexual orientation, gender or gender conformity, genetic information, marital status, individuals with disabilities, or veteran status, and/or veterans of the Vietnam era. It is our intent and desire that equal employment opportunities will be provided in employment, recruitment, selection, compensation, benefits, promotion, demotion, layoff, termination and all other terms and conditions of employment. IMPORTANT, PLEASE READ AND SIGN: I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can be grounds for termination from the company. I understand that if I am employed, it will be "AT WILL" and is for no definite time and may be terminated by the company or me at any time without prior notice.

“AN EQUAL OPPORTUNITY EMPLOYER”