2836 Clovis Rd, Lubbock, TX 79415 806.771.6440
Please enter your information below, we will not ask for sensitive information online, but ask that you be prepared to do so on coming in to our office for an interview.
Your Name
Date
Phone #
Message #
Your Email (if available)
Date Available for Work
Wage Requested
Willing to travel? —Please choose an option—YesNo
Special licenses:
High School
Relevant Courses
Diploma —Please choose an option—YesNo
College
Degree
Trade/Business School
Certification
Other Training
Work Experience and Special Skills
Starting with the most recent
Former Employer 1
Date Hired
Date Left
Rate of Pay
Position
Reason for Leaving
Former Employer 2
Former Employer 3
Known for at least 1 year
Name
Address
Do you have any limitations which would prohibit you from performing any task? If yes, Please explain:
If applicable
Drug Screen Policy Initial Hire: New hires are required to take a drug screen. If you are found to be positive, you will not be hired. Probable Cause: If you are suspected of drug use or sales, you will be required to take a drug test. If the results are positive, you will be required to pay for the test, and may be terminated. Injury: If you are injured on the job and have to seek medical attention, you will be required to take a drug test. If the results prove to be positive, you are responsible for the payment of the drug test, and may be terminated. Refusal: Refusal to take a drug test under any circumstances may result in immediate termination.
You will be required to sign an employment contract again outlining the above.
I have read and understand the Drug Screen Policy and agree to the conditions.
I have the read Safety Statement and agree to the conditions.
I have read the Code of Conduct and agree to the conditions.
I certify that my responses above are true and complete. I understand that the West Materials, LLC will rely on this information. Untrue or incomplete response may disqualify me from collecting workman’s compensation benefits for later, related on-the job injuries and may be grounds for discharge.
I authorize West Materials, LLC to obtain information from any prior employer regarding me, and I release West Materials, LLC and all prior employers from liability arising from the release of information about me.
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