Employment: Apply Online


916 Blake Street
PO Box 82
Blanchardville, WI 53516
Office: 608.523.4290  Fax: 608.523.4292

J&R Underground, LLC

Employment Application
www.jrundergroundllc.com

Applicant Information
Last Name
 First
 M.I.
 Date
Street Address
 Apartment/Unit #
City
State
 ZIP
Home Phone
Cell Phone
E-mail Address
Date Available
Desired Hourly Wage
$ 		Position Applying for
Are you a citizen of
the United States? 		YES    NO If no, are you authorized to work in the U.S.? YES    NO
Have you ever worked
for this company?		 YES    NO If so, when?
Have you ever been
convicted of a felony?		 YES    NO If yes, explain
Are you affiliated with
a labor union?		 YES    NO If yes, which?
Do you have a valid CDL
(any restrictions)?		 YES    NO Explanation:
Previous Employment
Employer 1
Company
 Phone
Address
Supervisor – Name/Phone
Job Title
Starting Wage $ Ending Wage $
Responsibilities
  
From To Reason for Leaving:
May we contact your previous supervisor for a reference? YES    NO  
Employer 2
Company
 Phone
Address
Supervisor – Name/Phone
Job Title
Starting Wage $ Ending Wage $
Responsibilities
  
From To Reason for Leaving:
May we contact your previous supervisor for a reference? YES    NO  
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.  If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature Date
   
  Click continue to review your application.

 

 
phone Contact Us
916 BLAKE STREET, P.O. BOX 82, BLANCHARDVILLE, WI 53516
Toll Free 1.866.370.2243 • Office: 608.523.4290 • Fax: 608.523.4292 • e-mail: info@jrundergroundllc.com