If yes, provide state, date of issue, number, expiration date and endorsements:

Do you have your own craft tools, clothing and other equipment?   Yes   No

List special equipment experiences:

REFERENCES (Give the names of two persons not related to you whom you have known for at least one year.)

It is the policy of this company to employ only those individuals who are legally eligible for employment in the United States.  The immigration Reform and Control Act of 1986 requires that, should an offer of employment be extended, before you begin employment you will be required to submit to this company certain documents for review which verify both your employment authorization and your identity.  Copies of the documents you may have to submit will be made and retained by the company for the period of time prescribed by law.

Can you, after employment, submit verification of your legal right to work in the United States? Yes   No

I hereby authorize investigation of all statements contained in this application, I understand that misrepresentation or omission of facts called to is cause for dismissal.  I further understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without previous notice.

Tucson Asphalt is an Equal Opportunity Employer, and does not discriminate in the basis of race, religion, color, sex, age, national origin, or disability.  Employment Applications become inactive 60 days from date signed.  Reapply after 60 days to insure current employment application status.  To be considered for employment, application must be dated and signed.