LIBERTY PRECAST | EMPLOYMENT FORM

Physical Address:
Liberty Precast, L.L.C.
1999 N. Birch
Jenks, OK 74037

Mailing Address:
Liberty Precast, L.L.C.
P.O. Box 156
Jenks, OK 74037

Telephone Numbers:
Main Office Number: 918.298.9080
Fax Number: 918.298.7274
* Our offices are open M-F 8:00 AM to 5:00 PM

Equal Opportunity Employer:

It is the policy of Liberty Precast, L.L.C. to assure that applicants are considered and that employees are treated fairly during their employment, without regard to race, color, religion, age, physical or mental disability, sex, marital status, ancestry, national origin, veteran’s status, citizenship, pregnancy, sexual orientation, other protected activities, or any other characteristic protected by federal, state, or local law. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; wages or other forms of compensation; selection for training, including apprenticeship, pre-apprenticeship, and/or on the job training; and ensuring and maintaining a work environment free of harassment, intimidation, and coercion at all sites and in all facilities at which employees are assigned to work.

Please Note: Liberty Precast, L.L.C. requires pre-employment physicals and may need additional information from you to complete the employment process.

Applicants Personal Information Section:

Please fill in the fields below regarding general personal information.
Your Legal Name: * Title First Last Suffix
Please tell us your legal name.
Your Phone Number: * - (###) - ### ####
Please tell us a good contact number. This number will be used to contact you regarding this application.
Your E-Mail Address (Optional):

Please tell us your contact e-mail address.
Your Current Address: *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please tell us your current address.
How Long Have You Lived At Your Current Address: *

Please select how many years you have lived at the address provided above.
If Under 18, Please List Age:

Please enter you age if you are under 18 years of age.
Military Section:

Please tell us your previous or current military history.
Have You Ever Been In The Armed Forces: * Yes No Prefer not to say
Please tell us if you have ever been in the Armed Forces.
Are You Currently A Member Of The National Guard: * Yes No Prefer not to say
Please tell us if you are currently a member of the National Guard.
If Yes, What Is/Was Your Speciality:

Please tell us your speciality in the armed forces.
Date Entered: / MM / DD YYYY
Please tell us the date you entered the Armed Forces/National Guard.
Date Discharged: / MM / DD YYYY
Please tell us the date you were discharged from the Armed Forces/National Guard.
Driver's License and Transportation Information:

Please fill out the information below regarding your driver's license and mode of transportation.
Do You Have A Driver's License: * Yes No
Please tell us if you have a driver's license.
What Type Of Driver's License Do You Have, If Applicable: *

Please tell us the type of driver's license you have, if you do not have one select "None".
Have You Had Any Accidents In The Past Three Years: * Yes No Do not have a driver's license
Please tell us if you have had any accidents in the past three years.
Have You Had Any Moving Violations In The Past Three Years: * Yes No Do not have a driver's license
Please tell us if you have had any moving violations in the past three years.
Work Avaiability Section:

Please tell us your avaiability for work.
How Many Hours Can You Work Weekly: *

Please tell us how many hours you can work weekly.
Can You Work Nights: * Yes No
Please tell us if you can work at night.
When Can You Start: * / MM / DD YYYY
Please tell us the date you would be willing to start work.
Salary/Hourly Requirements Section:

Please let us know your desired pay requirements.
Hourly Or Salary Payment Type Desired: * Hourly Salary (Annually)
Please select hourly or salary for the type of payment you would prefer to receive and then below fill in the amount desired.
Desired Pay Amount: * $ . Dollars Cents
Please tell us your salary/hourly requirements.
Employment Oppertunities Section:

Please complete the information below regarding the employment opportunities at Liberty Precast.
Position Desired: *

Please select the desired position that you are applying for.
Employment Desired: *

Please select the type of employment you desire.
Have You Ever Been Convicted Of A Crime: * Yes (If yes please explain below) No
Please tell us if you have ever been convicted of a crime.
Explination of Conviction: (Ignore if selected NO above)
If you answered yes to the above question, please explain the number of conviction(s), nature of offense(s), leading to conviction(s), how recently such offense(s) was/were committed, sentenced(s) imposed, and type(s) of rehabilitation.
If you answered NO to the above question, you can ignore this question.
Education History:

If applicable, please complete the information below regarding education history.
School #1:

If applicable, please complete the information below regarding the main school you attended.
Type of School: *

Please tell us the type of schooling you have had, if applicable.
Name of School:

Please tell us the name of the above selected school, if applicable.
Address of School:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please tell us the address of the above selected school, if applicable.
Number of Years Completed:

Please tell us the number of years completed at the above selected school, if applicable.
Major or Degree:

Please tell us the major and/or degree completed at the above selected school, if applicable.
Additional Infromation You Want Us To Know:

Please let us know if there is any additional information regarding your schooling that you would like us to know.
School #2:

If applicable, please complete the information below regarding any other school you attended.
Type of School:

Please tell us the type of schooling you have had, if applicable.
Name of School:

Please tell us the name of the above selected school, if applicable.
Address of School:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please tell us the address of the above selected school, if applicable.
Number of Years Complete:

Please tell us the number of years completed at the above selected school, if applicable.
Major or Degree:

Please tell us the major and/or degree completed at the above selected school, if applicable.
Additional Infromation You Want Us To Know:

Please let us know if there is any additional information regarding your schooling that you would like us to know.
Personal References Section:

Please provide us with two references other than family or previous employers.
Reference #1:

Please provide us with your main personal reference.
Reference Name: *

Name of reference #1.
Reference Contact Number: * - (###) - ### ####
Phone number for reference #1.
Reference #2:

Please provide us with your secondary personal reference.
Reference Name: *

Name of reference #2.
Reference Contact Number: * - (###) - ### ####
Phone number for reference #2.
Work Experience:

Please list your past two employers, beginning with your most recent job held. If you were self employed, please give a firm name.
Employer #1:

Please fill out the fields below regarding your most recent employer. If you have been previously employed, please fill out this information. It will help us process your applications more quickly and efficiently. If you have not been previously employed please select "NO" and move on to the next section.
Have You Been Previously Employed: * Yes No
Please tell us if you have been previously employed, if no move on to the section below; if yes, please fill out the rest of the form below.
Name of Employer:

Name of employer.
Address Of Employer:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please provide us with the address of your previous employer listed above.
Name Of Last Supervisor: First Last
Please tell us the name of your previous supervisor from the employer listed above.
Employed From: (Start Of Employment) / MM / DD YYYY
Please tell us the date you were hired for the above employer.
Employed To: (End Of Employment) / MM / DD YYYY
Please tell us the date you left the above employer.
Starting Pay: $ . Dollars Cents
Please tell us the pay your received when hired from the above employer.
Ending Pay: $ . Dollars Cents
Please tell us the pay your received when leaving the above employer.
Your Last Job Title:

Please tell us your job title from the above employer.
Reason For Leaving: (Please Be Specific)

Please tell us your reason for leaving the above employer.
Jobs Held, Duties Preformed, Skills Used/Learned, Advancements/Promotions Received:

Please tell us the Jobs Held, Duties Preformed, Skills Used/Learned, Advancements/Promotions Received while at the above employer's business.
Employer #2:

Please fill out the fields below regarding your second most recent employer. If you have been previously employed, please fill out this information. It will help us process your applications more quickly and efficiently.
Name of Employer:

Name of employer.
Address Of Employer:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Please provide us with the address of your previous employer listed above.
Name Of Last Supervisor: First Last
Please tell us the name of your previous supervisor from the employer listed above.
Employed From: (Start Of Employment) / MM / DD YYYY
Please tell us the date you were hired for the above employer.
Employed To: (End Of Employment) / MM / DD YYYY
Please tell us the date you left the above employer.
Starting Pay: $ . Dollars Cents
Please tell us the pay your received when hired from the above employer.
Ending Pay: $ . Dollars Cents
Please tell us the pay your received when leaving the above employer.
Your Last Job Title:

Please tell us your job title from the above employer.
Reason For Leaving: (Please Be Specific)

Please tell us your reason for leaving the above employer.
Jobs Held, Duties Preformed, Skills Used/Learned, Advancements/Promotions Received:

Please tell us the Jobs Held, Duties Preformed, Skills Used/Learned, Advancements/Promotions Received while at the above employer's business.
General Notes, Questions, Comments Section:

Please fill out the box below with any additional information you would like us to know.
Notes/Questions/Comments:

Please tell us if you have any questions, comments, or general information you would like us to know in this field.
Content Agreement:

You swear or affirm under the penalty of false swearing that all information provided on this application is true, correct, and complete to the best of your knowledge. You understand that any false statements, misrepresentations, or omissions of fact in or with this application are grounds for enforcement under applicable law. Further, you understand that the information you have provided Liberty Precast, L.L.C. with on this form will be sent/transmitted without the SSL encryption. Additonally, you understand that there may be additional steps and information needed from you to complete the employment process. By checking the box below you agree to be bound by this agreement.
Content Agreement Acknowledgement: * I agree to be bound by the Liberty Precast, L.L.C. Content Agreement.
Privacy Policy:

We at Liberty Precast, L.L.C. respect and take privacy very seriously. The information you have provided us with on this form will not be advertised, sold, or released to any third-parties. All form submissions are treated as confidential. By checking the box below you are acknowledging this statement.
Privacy Policy Acknowledgement: * I have acknowledged the Liberty Precast, L.L.C. Privacy Policy.
Spam Protection:

Please enter the required information below to submit your form.

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