Application for Employment

CCI provides equal opportunity for all qualified applicants and employees without regard to race, color, gender, national origin, religion, age, sexual orientation, gender identity, genetic information, physical or mental disability, pregnancy, marital status, status as a protected veteran, or any other status protected by federal, state, or local law. CCI also provides reasonable accommodations to qualified individuals with disabilities, in accordance with the Americans with Disabilities Act and applicable state and local laws. A copy of CCI's Affirmative Action Program (AAP) is available for review upon request.


  1. I understand that the information will be used and that prior employers will be contacted for purposes of investigation as required by 301.23, of the Federal Motor Carrier Safety Regulations.
  2. Furthermore, in making this application for employment, I understand that an investigation may be made whereby information is obtained through personal interviews with third parities such as family members, business associates, financial sources, friends, neighbors, or others whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, mode of living, or whichever may be applicable. I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation in compliance with Section 606-(A) (1) of the Fair Credit Reporting Act.

(by entering your initials, you signify your agreement with the above statements)

Personal Information Part 1

Personal Information Part 2

(Proof of eligibility will be required upon offer of employment.)

(If no, you may be required to provide authorization.)

(If you have any questions about the function of this job, please ask before answering this question.)

(A conviction will not necessarily disqualify you.)

(A conviction will not necessarily disqualify you.)

Education and Training

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Work Experience

Special Skills and Qualifications

(Indicate number of years experience n the box next to each skill.)

Other Skills


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Certification, Authorization and Agreement

By submitting this application, I herby certify that all statements made are complete and true, to the best of my knowledge. I understand and agree that any false or misleading statements shall be considered sufficient cause for employment disqualification or discharge from employment. I authorize my current and former employers to provide Carstensen Contracting all available information regarding employment. I authorize all schools, colleges and universities that I have attended to provide Carstensen Contracting all available information regarding my education. I understand that, as a condition of employment, I must provide documentation to Carstensen Contracting within three (3) days after my employment to prove United States citizenship or the right to work in the United States. I authorize Carstensen Contracting to review all driving record information available.

Today's Date: 12-07-2022