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Pre-employment Application

Thank you for your interest in building a future with FMGI.

Here are a few things you need to know before you get started.

To complete the application, you will need:

Social Security + Driver’s License Numbers
Conviction details (if applicable)
Employment history (company name address/phone/dates of employment, supervisor name, position, salary, reason for leaving)
Education + Military service record

About this application:

If an item is not required (*) and is not applicable to you, please leave the field blank.
Once you hit “submit”, whatever information you have completed on the form will be submitted.
You cannot save your data for future submission.
You can skip non-required questions in a section and come back to that section without losing any data as long as you have not hit the submit button.
You will receive a confirmation email that contains your responses once you hit the “submit” button.
Any revisions to your application will need to be emailed to cassie.dick@fmgi-inc.com.

Step 1 of 4

25%

Current Information
First Name*
Last Name*
Mobile Phone*
Home Phone
Office Phone
Email*
What is best way to contact you?
Current Address*
Street Address Address Line 2 City State ZIP Code
Social Security Number*
Are you over 18?*
- Yes
- No
Are you a citizen of the U.S. or do you have the legal right to be employed in the United States?*
- Yes
- No
Have you ever been convicted of any crime (excluding minor traffic violations) including DWI?*
- Yes
- No
NOTE: A CONVICTION WILL NOT NECESSARILY DISQUALIFY YOU FROM EMPLOYMENT.
State the offense, location, date and disposition.
Driver License*
State
License Number*
License Type
Is License Currently Valid*
- Yes
- No
If you worked in any of your previous positions under another name, please give that name(s).
Are you presently employed?*
- Yes
- No
May we contact your present employer?
- Yes
- No
Have you ever been fired, or asked to resign from a job?*
- Yes
- No
Please explain.
Are you seeking?*
- full-time
- part-time
- temporary or summer employment
Is there are specific position you are applying for?
Annual Salary Desired
Date Available to Start
MM slash DD slash YYYY
Have you ever worked for our company before?*
- Yes
- No
State when and where you worked.
Are you now, or do you expect to be, working in any other business or job?*
- Yes
- No
Please explain.
Do you have any obligations or other reasons, which would limit your ability to travel or work overtime?*
- Yes
- No
Please explain.
Would you be willing and able to relocate?*
- Yes
- No
Are there any days or hours you would be unable or unwilling to work?*
- Yes
- No
Please specify those days or hours you would be unable or unwilling to work.

Employment History
Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer.
Employment Record 1
Company Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Starting Pay
Ending Pay
Name of Supervisor
Your Title
Describe Your Roles and Responsibilities
Reason for Leaving
Employment Record 2
Company Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Starting Pay
Ending Pay
Name of Supervisor
Your Title
Describe Your Roles and Responsibilities
Reason for Leaving
Employment Record 3
Company Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Starting Pay
Ending Pay
Name of Supervisor
Your Title
Describe Your Roles and Responsibilities
Reason for Leaving
Employment Record 4
Company Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Starting Pay
Ending Pay
Name of Supervisor
Your Title
Describe Your Roles and Responsibilities
Reason for Leaving
Employment Record 5
Company Name
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Employed From
MM slash DD slash YYYY
Employed To
MM slash DD slash YYYY
Starting Pay
Ending Pay
Name of Supervisor
Your Title
Describe Your Roles and Responsibilities
Reason for Leaving

Education
High School
High School Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date From
MM slash DD slash YYYY
Date To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Courses studied
College
College Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date From
MM slash DD slash YYYY
Date To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Courses studied
Trade School
Trade School Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date From
MM slash DD slash YYYY
Date To
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
Courses studied
If you did not graduate, why did you leave high school or college?
Are you planning to pursue further studies?
- Yes
- No
When, where and what courses?
List any scholastic honors, offices held and activities involved in during high school and college.
List and describe any other school or specialized training.
Service Record
Have you ever served in the military?
- Yes
- No
Are you a member of a reserve organization?
- Yes
- No
Service Branch
Final Rank
Date Entered
MM slash DD slash YYYY
Date Separated
MM slash DD slash YYYY

Responsibilities
Is there any reason you would be unable or unwilling to perform any of the tasks required by the job you are applying for?
- Yes
- No
Explain which tasks
Have you filed any type of fraudulent claim against any of your present or past employers?
- Yes
- No
Please explain
Will you abide by the safety rules of this company?
- Yes
- No
Have you ever been disciplined for violating company safety rules or regulations?
- Yes
- No
Please Explain
How many days of work (or school) have you missed in the last two years?
Please enter a number from 0 to 730.
What were the reasons for your absence?
How many times have you been late for work (or school) in the last two years?
Please enter a number from 0 to 730.
What were the reasons for your late arrivals?
Is there any reason why you would be unable or unwilling to report to work on time every day on a regular and consistent basis?
- Yes
- No
Please explain why
Do you have any training in First Aid or CPR?
- Yes
- No
Which one(s)?
Do you have any safety training?
- Yes
- No
Do you read blueprints?
- Yes
- No
Do you know how to use a level or transit?
- Yes
- No
Do you have a powder actuated tool certificate?
- Yes
- No
Do you have a laser-training certificate?
- Yes
- No
What concrete forming systems have you used?
Do you have any heavy equipment experience?
- Yes
- No
List equipment type
Have you had any computer or word processing experience or training?
- Yes
- No
List software and programs
What languages do you speak fluently?
Use this space below to describe why you are interested in working for our company and to list those skills and abilities which you feel particularly qualify you for a position with us.
AFFIDAVIT*
I certify that my answers to the questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate discharge.

I hereby authorize the Company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy or any other reason because of their statements.

I agree that, if I am employed, I will abide by all the rules and regulations of the company. ALL APPLICANTS MUST SUBMIT TO, AND PASS, AN ALCOHOL AND DRUG TEST AS A CONDITION OF EMPLOYMENT. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are a condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the President of the Company. I also understand that my employment is “at-will” and may be terminated by myself or by the company at any time for any reason or no reason at all, with or without prior notice.

Our Company is an equal opportunity employer and will consider all applicants for all positions equally without regard to their race, sex, age, color, religion, national origin, veteran status or any disability, which is not job-related.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed. Each question should be answered in a complete and accurate manner as no action can be taken on this application until all questions have been answered.
I certify the information provided and agree to the statements above.

Building Excellence.

FMGI – Atlanta
130 Arnold Mill Park
Suite 100
Woodstock, GA 30188
(678) 903-2200

FMGI – Alabama
2825 Highway 205 S
P.O. Box 2397
Albertville, AL 35950
(855) 279-0490

FMGI – Tampa
13595 Sheldon Road
Tampa, FL 33626
(727) 372-7100

FMGI – Dallas
4275 Kellway Circle
Suite 118
Addison, TX 75001
(469) 638-9517

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