LITTLE Builders | Online Employment Application WWW.LITTLEBUILDERS.COM

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PERSONAL     *First Name Middle *Last *Street Address *City *State *Zip *Home Phone Cell Phone email address Social Security Number Marital Status *Position Applying For    Salary Requirements (yearly) $ --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- EDUCATION *Check the Highest Grade Completed 1 2 3 4 5 6 7 8 9 10 11 12                         If you did not complete high school, do you have a high school equivalency diploma? Yes No       Check number of years of post high school education 1 2 3 4 5 6 7   Institution Name/ Location Hrs Degree Received Major/Specialty Minor Dates Attended             -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- EXPERIENCE Starting with the most recent, describe ALL paid, military, and applicable voluntary experience. Highlight your knowledge, skills and abilities which best demonstrate your qualifications for this position. You may list significantly different jobs within the same organization as separate items. May we contact your current supervisor? Yes No Job Title Employer Address City State/Zip Phone Type of Business Immediate Supervisor Title Job Duties Salary (start) (finish) Dates (mo/yr) to (mo/yr) Full Time Part Time Hours/week     Equipment Used Reasons for Leaving  Job Title Employer Address City  State/Zip  Phone Type of Business Immediate Supervisor Title Job Duties Salary (start) (finish) Dates (mo/yr) to (mo/yr) Full Time Part Time Hours/week     Equipment Used Reasons for Leaving   License (to include driver’s), certificate or other authorization to practice a trade or profession. Type License Number Granted by (licensing board)        ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------  REFERENCES Name Address Phone # Relationship          ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------  MISCELLANEOUS In compliance with The Immigration Reform and Control Act*, are you legally eligible for employment in the United States? Yes No * Immigration Reform and Control Act of 1986, requires you to provide documentation to that effect should you be employed.   Have you ever been convicted for any violation(s) of law, including moving traffic violations? Yes No If Yes, please provide the following: Description of offense   Stature or ordinance (if known) Date of charge   County, City State of Conviction  -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Will you will be available to start work? (No date is necessary if you are available as soon as you give two weeks notice.) Month Day Year By submitting this form, I hereby certify that all entries on both sides and attachments are true and complete, and I agree and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment in Little Builders, Inc. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent that you may contact references, former employers and educational institutions listed regarding this application. I further authorize Little Builders, Inc. to rely upon and use, as it sees fit, any information received from such contacts.  -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------  < You may attach your resume with this application (file size not to exceed 1mb)