4SEMO Residential & Commercial Construction Services, serving all of Southeast Missouri, with the showroom in Malden, Missouri.

Please complete all fields. Type "n/a" where applicable. An incomplete application will not be considered. All fields are required.

If you would like to mail the application, click here for the printer version. Please mail completed application to: P.O. Box 404, Malden, MO 63863 or fax to (573) 276-3984.

Applicant Information
Last Name:
First Name: MI:
Maiden Name: SSN:
Present address: City:
State Zip:
How long at current address?
Phone: (include area code, only use numbers)
Are you under age 18? YES NO
if “YES”, can you provide work eligibility proof? YES NO
Are you currently authorized to work in the United States? YES NO Proof of eligibility will be required if hired.

Position applied for:
Wage desired:
Days available to work: Mon. - Fri. Tue. - Sat. No Preference
How many hours can you work each week?
Type of Employment desired:
When are you available to start work?
Have you ever been convicted of a felony? YES NO
(A conviction record will not necessarily disqualify you from employment)
If Yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such conviction(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.
Do you have a valid Driver's License? Yes No
What is your means of transportation to work?
Driver’s license number:
State of issue:
License Classification:
Date License Expires:
Have you had any accidents during the past 3 years? Yes No
If Yes, how many?
Have you had any moving violations during the past 3 years? Yes No
If Yes, how many?
Have you ever been in the Armed Forces? Yes No
Are you currently a member of the National Guard? Yes No
Specialty:
Date Entered:
Date Discharged:

Education
Type of School	School Name	Location (Mailing Address)	Number of Years Completed	Major & Degree
High School
College
Business/ Trade School
Professional School
For Applicants applying for Office Positions only:
Select all of the following in which you are proficient:
	Word Processing
	Typing
	10Key
	IBM PC
	Mac
	WPM
Other Skills:

Personal References

Please list two references other than relatives.

Name:
Position:
Company:
Address:
Phone:

Name:
Position:
Company:
Address:
Phone:

Please use this space to elaborate on any background, experience or qualifications that you believe should be considered in evaluating your qualifications for employment. You may include hobbies, volunteer experience and any other activities you believe relevant. Please omit any
information that would disclose your race, gender, age, marital status, ethnic origin, religious or political affiliations or disability.

Work Experience
Please list your work experience for the past seven years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets, if necessary.
Employer:		Address:
City, State, Zip
Phone:	Name of last supervisor:
Date started:	Start Pay/Salary
Date ended:	End Pay/Salary
Job title:
Reason for leaving (be specific):
List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:
May we contact your present employer? Yes No

Employer:		Address:
City, State, Zip
Phone:	Name of last supervisor:
Date started:	Start Pay/Salary
Date ended:	End Pay/Salary
Job title:
Reason for leaving (be specific):
List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

Employer:		Address:
City, State, Zip
Phone:	Name of last supervisor:
Date started:	Start Pay/Salary
Date ended:	End Pay/Salary
Job title:
Reason for leaving (be specific):
List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

Did you complete this application yourself? Yes No
If not, who did?
Are you able to perform the essential functions of the job for which you have applied ? Yes No
If No, please identify those job functions that you cannot perform.
If a reasonable accommodation is required to enable you to perform the job properly and safely, please describe:

Application Form Waiver (Please read carefully)
As indication that you have read and understood each sentence, please type your initials into the fields provided below.
In exchange for the consideration of my job application by 4SEMO.COM, INC., (hereinafter called “the Company”), I agree that: My employment is on an as needed, part time basis with no guarantee of days or hours per pay period until such time that I have completed my 90-day probationary period after which I will be eligible to apply for a full time position with the company if a full time position is available. Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of 4SEMO.COM, INC., or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Owner/Managing Member of the Company. Both the undersigned and 4SEMO.COM, INC. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, all previous employers (unless otherwise indicated), references and others and hereby release the Company from any liability as a result of such contact. I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. I further understand that my employment with the Company shall be probationary for a period of ninety (90) days and further that at any time during the probationary period or thereafter, my employment relationship with the Company is terminable at will for any reason by either party.
Typing your name into this space signifies signature of applicant.

Date:

4SEMO.COM, INC. is an equal employment opportunity employer.
We adhere to a policy of making employment decisions without regard to race, color, religion, gender, orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with 4SEMO.COM, INC. depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.

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