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Career Application

Home » Career Application

Application For Employment

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Thank you for your interest in applying for employment! This application will take 20-30 minutes to fill out, and will collect some basic information about you, your employment history, educational background, and more. Please have ready the contact information for your last four employers, as well as three business/work references we can contact.
Position(s) Applied For*
Date of Application*
MM slash DD slash YYYY
Referral Source*
- Career Fair
- Company Website
- Employee Referral
- Indeed
- Zip Recruiter
- Social Media Site
- Other Online Job Board
- Other
Employee Referral Name*
Other Referral Source
Name of Source (If Applicable)

Applicant Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*

Are you over 18?*
- Yes
- No
If you are under 18, can you furnish a work permit?
- Yes
- No
Have you ever been employed here before?*
- Yes
- No
Employed here from
MM slash DD slash YYYY
Employed here to
MM slash DD slash YYYY
Are you legally eligible for employement in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment.)*
- Yes
- No
Date available for work*
MM slash DD slash YYYY
Type of employment desired*
- Full Time
- Part Time
- Temporary
- Seasonal
Do you have a valid Driver's License?*
- Yes
- No
Do you have a Commercial Driver’s License?*
- Yes
- No
Will you relocate if job requires it?*
- Yes
- No
Will you travel if job requires it?*
- Yes
- No
Are you currently a union member?
- Yes
- No
What local union are you currently in?

List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comments section below.
Employer
Phone
Job Title
Reason for Leaving
May we contact for reference?
- Yes
- No
- Later
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Summarize the nature of the work performed and job responsibilities*
More work history to add?
- Yes
- No
Employer 2
Employer
Phone
Job Title
Reason for Leaving
May we contact for reference?
- Yes
- No
- Later
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Summarize the nature of the work performed and job responsibilities*
More work history to add?
- Yes
- No
Employer 3
Employer
Phone
Job Title
Reason for Leaving
May we contact for reference?
- Yes
- No
- Later
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Summarize the nature of the work performed and job responsibilities*
More work history to add?
- Yes
- No
Employer 4
Employer
Phone
Job Title
Reason for Leaving
May we contact for reference?
- Yes
- No
- Later
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Summarize the nature of the work performed and job responsibilities*

Comments (including explanation of any gaps in employment)
Skills and Qualifications
Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work with our company.

Educational Background (if job related)
A. School

List last school/s attended, starting with the last one.
B. Years Completed
List number of years completed.
C. Degree/Diploma

Indicate degree or diploma earned if any.
D. Major

Major field of study (if applicable)
More schooling to add?
- Yes
- No
School 2
A. School
B. Years Completed
C. Degree/Diploma
D. Major
More schooling to add?
- Yes
- No
School 3
A. School
B. Years Completed
C. Degree/Diploma
D. Major

It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. I give the Employer the right to investigate all references to secure additional information about me, if job-related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. The Employer is an Equal Opportunity Employer. Then Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state, or federal law. This application is currently only for 60 days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary to fill out a new application. I understand the just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary. I understand that any offer of employment made by the employer is contingent upon passing a drug test.
I agree to the terms of service
- Yes
- No

TL Nexlevel, LLC is an Equal Opportunity Employer. As required by law, we must record certain information to be made a part of our Affirmative Action Program. Applicants for employment are also invited to participate in the Affirmative Action Program by reporting their status as disabled, disabled veteran, veteran of the Vietnam era or other minority. In extending this invitation you are also advised that: (a) workers (applicants) are under no obligation to respond, but may do so in the future if they choose; (b) responses will remain confidential within the Human Resources Department; and (c) responses will be used only for the necessary information to include in our Affirmative Action Program. We are a company that values diversity. We actively encourage women and minorities to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment. Please complete the information requested below. Thank you for your cooperation.
Gender
- Male
- Female
Race or Ethnic Identity
- Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.
- White (not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
- Black or African American (not Hispanic or Latino): A person having origins in any of the black racial groups of Africa.
- Native Hawaiian or Pacific Islander (not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
- Asian (not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
- American Indian or Alaskan Native (not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
- Two or More Races (not Hispanic or Latino): All persons who identify with more than one of the above five races.
Veteran Status
- Vietnam Era Veteran: Defined as (a) an active duty wartime or campaign badge veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense. (b) an Armed Forces service medal veteran veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 FR 1209).
- Disabled Veteran: Defined as (1) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (2) a person who was discharged or released from active duty because of a service-connected disability.
- Special Disabled Veteran: Defined as a veteran who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Department of Veterans Affairs for a disability: 1. Rated at 30 percent or more; or 2. Rated at 10 or 20 percent in the case of a veteran who has been determined under 38 U.S.C. 3106 to have a serious employment handicap; or 3. A person who was discharged or released from active duty because of a service-connected disability.
- Other Protected Veteran: Defined as a person who served on active duty for a period of more than 180 days, and was discharged or released therefrom with other than a dishonorable discharge, if any part of such active duty occurred: * in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or * Between August 5, 1964, and May 7, 1975 in all other cases; or * Was discharged or released from active duty for a service-connected disability if any part of such active duty was performed in the Republic of Vietnam between February 28, 1961, and May 7, 1975; or between August 5, 1964, and May 7, 1975, in all other cases.
- Recently Separated Veteran: Any veteran who served on active duty in the U.S. military, ground, naval or air service during the one year period beginning on the date of such veteran's discharge or release from active duty.
- Armed Forces Service Medal Veterans: Defined as any veteran who, while serving on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense.
- I am not a veteran.
- I do not wish to Self-identify

Why are you being asked to complete this form?
Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way. If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition. Disabilities include, but are not limited to: • Blindness • Autism • Bipolar disorder • Post-traumatic stress disorder (PTSD) • Deafness • Cerebral palsy • Major depression • Obsessive compulsive disorder • Cancer • HIV/AIDS • Multiple sclerosis (MS) • Impairments requiring the use of a wheelchair • Diabetes • Epilepsy • Schizophrenia • Muscular dystrophy • Missing limbs or partially missing limbs • Intellectual disability (previously called mental retardation)
Please check one of the boxes below:*
- YES, I HAVE A DISABILITY (or previously had a disability)
- NO, I DON'T HAVE A DISABILITY
- I DON'T WISH TO ANSWER
Reasonable Accommodation Notice
Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.
Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp. PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.
Signature
Date
MM slash DD slash YYYY
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UTILITIES CONSTRUCTION CONTRACTOR

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Minnesota Office

500 County Rd 37 E
Maple Lake, MN 55358
320-963-2400
800-245-5732

Texas Office

14140 Cypress N Houston
Cypress, TX 77429
281-477-6662
800-577-9365

California Office

266 Industrial Road
Suite B
San Carlos, Ca. 94070
650-486-1359

© 2023 MP Nexlevel LLC. All right reserved |
MP Nexlevel LLC is a subsidiary of APi Group, Inc.
APi Group is a trademark of API Group, Inc. It is registered in the United States and in many other countries.
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