Apply Now! Download Blank Employment Application Please enable JavaScript in your browser to complete this form.P. A. Landers, Inc. 351 Winter St, Hanover MA 02339Application For EmploymentIn compliance with Federal and State Employment Opportunity Laws, qualified applicants are considered for all positions without regard to race, color, religion, gender, national origin, age, marital status, sexual orientation, the presence of a non-job related medical condition or disability, or any other characteristic protected by law. Date *Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Are You over 18 years old? *YesNoAuthorized to work in the USA? *YesNoPosition Desired *How were you referred? *Date able to Start *Previously worked or applied for a job here? *YesNoLicenses/CertificationsCheck the boxes if you have any of the items listed below: *CDL LicenseHoist licenseOSHA 10 cardTWIC cardNoneWork HistoryPlease list your present or most recent job first. Include all employment, your work history, and any volunteer work. Note that CDL applicants require a ten (10) year work history. If you have a resume,' you may upload it below.Upload your resume Click or drag a file to this area to upload. Company #1 Name (most recent or current) *Company #1 Address *Company #1 Phone *Company #1 Job Title/Duties * Company #1 Dates Employed *Company #1 Reason for leaving *Company #2 Name Company #2 Address Company #2 Phone Company #2 Job Title/Duties Company #2 Dates Employed Company #2 Reason for leaving Company #3 Name Company #3 Address Company #3 PhoneCompany #3 Job Title/Duties Company #3 Dates Employed Company #3 Reason for leaving Company #4 Name Company #4 Address Company #4 Phone Company #4 Job Title/Duties Company #4 Dates Employed Company #4 Reason for leaving Company #5 Name Company #5 Address Company #5 Phone Company #5 Job Title/Duties Company #5 Dates Employed Company #5 Reason for leaving Company #6 Name Company #6 Address Company #6 Phone Company #6 Job Title/Duties Company #6 Dates Employed Company #6 Reason for leaving Additional Info (References)Military ServiceMilitary Service - BranchMilitary Service - RankMilitary Service - Discharge Date Physical HistoryList any restrictions and/or disabilities that may prevent you from doing certain types of work: *If applicable, are you physically capable of heavy, manual work? *YesNoHave you ever been injured on the job? *YesNoNature/Severity of injuryEducationName of High school/Vocational School *Dates attended *Courses studied *Did you graduate? *YesNoName of collegeDates attended Courses studied Did you graduate? YesNoName of Trade/Technical SchoolDates attended Courses studied Did you graduate? YesNoList any professional and/or technical licenses or any job related skill not listed above:Accident Record (CDL Applicants Only)Accident Record - Nature of accident #1Date - accident #1Fatality(s) accident #1YesNoInjury(s) accident #1YesNoAccident Record - Nature of accident #2Date - accident #2Fatality(s) accident #2YesNoInjury(s) accident #2YesNoAccident Record - Nature of accident #3Date - accident #3Fatality(s) accident #3YesNoInjury(s) accident #3YesNoDriving ExperienceDriving Experience - Type of Truck #1Dates Truck #1Approximate number of miles Truck #1Driving Experience - Type of Truck #2Dates Truck #2Approximate number of miles Truck #2Labor Experience (Masonry, Pipe, Asphalt, etc.)Labor Experience - Type of Labor 1Number of Months/Years -1Labor Experience - Type of Labor -2Number of Months/Years -2Labor Experience - Type of Labor -3Number of Months/Years -3Operator ExperienceType of Equipment -1Number of Months/Years Operated -1Type of Equipment -2Number of Months/Years Operated -2Type of Equipment -3Number of Months/Years Operated -3Maintenance ExperienceMaintenance Experience - Type of Maintenance -1Number of Months/Years -1Maintenance Experience - Type of Maintenance -2Number of Months/Years -2Special Courses or TrainingRequest for Check of Driving RecordSECTION 1. In accordance with the provisions of Section 604 and Section 607 of the Fair Credit Reporting Act, Public Law No. 91-508, I hereby certify that the information requested below will be used for a “permissible purpose” as defined in the Act, and that the information received will be used for no other purpose. SECTION 2. I further certify that if the applicant named below is denied employment based upon the information received, I will identify the source of the report in accordance with the Section 615 (a) of the Fair Credit Reporting Act. Date *PLEASE READ CAREFULLY AND SIGN THE STATEMENT BELOW:I CERTIFY that the information given above is true and complete and I understand that misrepresentation and /or withholding of information will result in the rejection of this application or my discharge if discovered after employment begins. I authorize the Company to make inquiries regarding my history and character of prior employers, schools, etc. and herby release employers, schools, or individuals from all liability in responding to inquiries in connection with my application and release the Company from all liability with respect to such inquiries. I UNDERSTAND that the Company has a drug/alcohol testing program and that I will be tested before my employment as well as being randomly tested during my employment. I also understand that failing the pre-employment drug/alcohol test will make me ineligible for employment and failing a random drug/alcohol test may result in termination of my employment with the Company. I UNDERSTAND that if employed, I will be an employee “at will” and may be terminated at any time, with or without cause, and with or without notice at the option of either the Company or myself. I also understand that no representative of the Company, other than the president, has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing. If I am employed, I agree to abide by the Company’s policies, rules, and procedures and any changes thereto. Date *Email *Email *PhoneSubmit