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Job Application

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Application Form
CG Schmidt is an Equal Opportunity Employer - Thank you for your interest
Name*
First Last
Address*
Street Address City State Zip
Daytime Phone Number*
Evening Phone Number
Email*
I can provide proof of a legal right to work in the USA*
- Yes
- No
If under 18 years of age, I can furnish a work permit*
- Yes
- No
I am willing to travel*
- Yes
- No
I am currently on a "lay off" status and subject to recall*
- Yes
- No
I was previously employed by CG Schmidt, Inc.*
- Yes
- No
If yes, please indicate in what capacity, when and to whom you reported:*
For position(s) requiring valid driver's license: I have a driver's licence:
- Yes
- No
If yes, please indicate:*
State & Driver's Licence Number
I have been convicted of a crime other than a minor traffic violation:*
- Yes
- No
If yes, please give date(s), offense(s), and charge(s)*
A conviction will not automatically bar you from employment. Each conviction will be considered with respect to time, circumstances, and relationship to job applied for.
I am related to a current CG Schmidt, Inc. employee*
- Yes
- No
If yes, please indicate below: Name(s), Relationship(s) & Department(s)*
How were you referred to us:
EMPLOYMENT DESIRED
Type of Work Desired
- Skilled Trades
- Office/Clerical/Administrative
- Management/Engineer
- Yard
Position(s) applying for:*
I am interested in:
- Full Time
- Part Time
Date you are able to start:*
MM slash DD slash YYYY
Salary Requirements:*
Rate of pay you expect per hour

EDUCATION
List your educational experience which you believe is relevant for the position you are applying for.
High School
or Elementary if you did not attend High School
Name and Location:*
Years Completed:*
Did You Graduate?*
- Yes
- No
Course of Study:*
Overall Grade Average:*
College
Name and Location:
Years Completed:
Did You Graduate?
- Yes
- No
Course of Study:
Overall Grade Average:
Other Education
Graduate work, trade school, other
Name and Location:
Years Completed:
Did You Graduate?
- Yes
- No
Course of Study:
Future Education
Do you plan on furthering your education?
- Yes
- No
If yes, when and what area?
List any additional achievements, activities, honors, organizations and offices held which you feel are pertinent to this application:

EMPLOYMENT EXPERIENCE
INCLUDE MILITARY EXPERIENCE
List part-time and full-time positions. List present or last positions first. Please answer all questions. Resumes are not substitutes, but may be attached.
Resume
Max. file size: 200 MB.
I am currently employed*
- Yes
- No
You may contact my present employer*
- Yes
- No
Employer 1
Company Name*
Name & Title of Immediate Supervisor:*
Company Address*
Street Address Address Line 2 City State ZIP Code
Starting Job Title:*
Ending Job Title:*
Job Duties:*
Dates of Employment*
MM/YYYY - MM/YYYY
Employment Status*
- Full-Time
- Part-Time
Starting Salary:*
Ending Salary:*
Reason for Leaving:*
Employer 2
Company Name
Name & Title of Immediate Supervisor:
Company Address
Street Address Address Line 2 City State ZIP Code
Starting Job Title:
Ending Job Title:
Job Duties:
Dates of Employment
MM/YYYY - MM/YYYY
Employment Status
- Full-Time
- Part-Time
Starting Salary:
Ending Salary:
Reason for Leaving:
Employer 3
Company Name
Name & Title of Immediate Supervisor:
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Starting Job Title:
Ending Job Title:
Job Duties:
Dates of Employment
MM/YYYY - MM/YYYY
Employment Status
- Full-Time
- Part-Time
Starting Salary:
Ending Salary:
Reason for Leaving:
Explain periods of unemployment in excess of three (3) months during the past 10 years:*

References
List 3 people - preferably past supervisors. Do not include relatives.
Reference 1
Name*
First Last
Occupation*
Years Known*
Phone Number*
Email*
Reference 2
Name*
First Last
Occupation*
Years Known*
Phone Number*
Email*
Reference 3
Name*
First Last
Occupation*
Years Known*
Phone Number*
Email*
KNOWLEDGE, SKILLS & ABILITIES
Skilled Trades / Yard Help
- Finish Carpenter
- Rough Carpenter
- Form Carpenter
- Fork Lift
- Concrete Laborer
- General Laborer
- Skid Loader
- Truck Driver
Other Education Training, Licenses or Special Skills:

CG SCHMIDT, INC. IS AN EQUAL OPPORTUNITY EMPLOYER
It is the policy of CG Schmidt, Inc. to employ qualified persons without discrimination against any employee or applicant for employment because of race, religion, color, sex, physical or mental disability, developmental disability, sexual orientation, national origin, age or status as a special disabled veteran or veteran of the Vietnam era, except where a bona fide occupational qualification exists under applicable regulation.
SUBSTANCE ABUSE TESTING & ASSISTANCE PROGRAM
Union employees will be tested in accordance with the terms of applicable testing policies. Non-union job applicants will be tested only after a conditional offer for employment is made, and present employees will be tested upon suspicion and after accidents causing personal injury or property damage. All employment offers are contingent upon the successful completion of our pre-employment drug screen program.
APPLICANT AUTHORIZATION
Please read thoroughly - then accept
All the information I have provided in support of this application for employment is true and correct to the best of my knowledge.I understand that:
- The issuance of this application does not indicate there are any positions open and does not in any way obligate CG Schmidt, Inc.
- Completed applications remain active for 60 days from the date I complete the form.
- I will not be paid for the time spent while applying for this position, taking a drug test, or any other processing prior to the beginning of employment.
- I agree to abide by all CG Schmidt, Inc. rules and regulations, which are in effect or may be established in the future if I am hired.
- If I am hired, completing this application for employment form does not change the fact that my employment is for an indefinite period of time, terminable at will by either the employer or me.
- All provisions are necessarily subject to change without notice.
- I am authorizing all corporations, companies, former employers, educational institutions, law enforcement agencies, city, state, county and federal courts, military services, and/or persons to release the information they may have about me to CG Schmidt, Inc. or their agents, and I release all parties involved from any liability and responsibility for doing so.
Acceptance & Signature*
- I agree to the above conditions and to CG Schmidt Privacy Policy
INVITATION TO IDENTIFY
We are subject to certain governmental record keeping and reporting requirement for the administration of civil rights laws and regulations. In order to comply with these laws, we are required to invite you to voluntarily self-identify your race, ethnicity, disability and veteran status. Submission of this information is voluntary, and refusal to provide it will not subject you to adverse treatment. The information obtained will be kept confidential, will be maintained separate from your application or personnel file, and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government. When reported, data will not identify any specific individual.
Name
First Middle Last
Gender:
- Male
- Female
Are you Hispanic or Latino?*
- Yes
- No
*A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish Culture or origin regardless of race.
If your answer above is "no", please identify your race
- White: A person having origins in any of the original people of Europe, the Middle East, or North Africa
- Asian: A person having origins in any of the original people of the Far East, Southeast Asia, or the Indian subcontinent, including, for example: Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, Philippine Islands, Thailand and Vietnam
- American Indian or Alaskan Native: A person having origins in any of the original people of North and South America (including Central America), and who maintain tribal affiliation or community attachment
- Black or African American: A personal having origins in any of the black racial groups of Africa
- Native Hawaiian or Pacific Islander: A person having origins in any of the people of Hawaii, Guam, Samoa, or other Pacific Islands
- Two or more races: All persons who identify with more than one of the above five races
Vietnam Era Veterans, other Eligible Veterans, Special Disabled Veterans and Individuals with Disabilities
Government contractors/subcontractors subject to the Vietnam Era Veterans Readjustment Act of 1974 and the Rehabilitation Act of 1973 are required to take affirmative action to employ and advance in employment Vietnam Era and other eligible Veterans, qualified special disabled veterans, and qualified disabled individuals.
Veteran of the Vietnam Era
A person who served on active duty for more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged with other than a dishonorable discharge. Veterans meeting the above criteria who served in the Republic of Vietnam between February 1961 and May 7, 1975 are also protected.
- Yes
- No
Other Eligible Veteran
A veteran who has served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized.
- Yes
- No
Special Disabled Veteran
A person entitled to compensation under laws administered by the Department of Veterans Affairs for a disability rated at 30% or more, or rated 10 or 20% in the case of a veteran was has been determined by the Department of Veterans Affairs to have a serious employment handicap, or a person whose discharge or release from Active duty was for a service-connected disability.
- Yes
- No
How Were You Referred to this Job?
- Advertisement
- School/College
- Employee Referral
- State Job Service
- Employment Agency
- Temporary Agency
- Government Agency
- Walk-In
- Recruiters
- Other
Disabled Individual
An individual who has a mental or physical impairment which substantially limits one or more major life activities, has a record of such impairment, or who is perceived as having such impairment.
- Yes
- No

CG Schmidt Headquarters

11777 West Lake Park Drive
Milwaukee, WI 53224

CG Schmidt Madison Office

433 West Washington Avenue
Madison, WI 53703

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