Employment Application

Applicant Information

Work Experience - Check all that are applicable
Are you at least 18 years of age?
Do you have a reliable method of transportation to shop or job site? Driver's license number required if driving may be required in the job for which you are applying?


Job Related Skills & Qualifications

Summarize any special training, skills, licenses and/or certifications that may assist you in performing the position for which you are applying.
List the equipment you can operate:




Current Employment


Previous Employment



Explain any gaps in your employment, other than those due to personal illness, injury or disability.

References Which We May Contact

Name Phone

Disclaimer and Signature

Lorne G. Seifert, LLC is an equal opportunity employer and does not discriminate in recruiting, hiring, training, promoting and other employment practices on the basis of race, color, family status, pregnancy, religion, ancestry, age, gender, sexual orientation, national origin, genetic information, physical or mental disability, veteran status or any other legally protected status.

Lorne G. Seifert, LLC does not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

By signing my name below, I certify that the answers given in this application of employment are true and correct to the best of my knowledge. I authorize such inquiry into the statements made in this application as may be necessary in reaching an employment decision. I understand that any false or misleading information given in this application or during a pre-employment interview, including a failure to disclose requested information, may result in discharge. I understand that I will be required to pass a physical examination, including drug test, before a final offer of employment is made. By signing my name below, I consent to these procedures.

I understand that any employment relationship with this employer is “at will”, which means that the employee may resign at any time and the employer may discharge that employee at any time, with or without cause.