English Application | Employment | Southeastern Construction

Today's Date*
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Are you 18 years of age or older?*
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Date of Birth*
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Name*
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Address*
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Phone*
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Consent & Disclosure for Background Identification Verification
IN ORDER TO VERIFY MY IDENTITY FOR THE PURPOSES OF BACKGROUND IDENTIFICATION FOR EMPLOYMENT WITH DIXIE SOUTHERN & SOUTHEASTERN CONSTRUCTION AND MAINTENANCE, INC., I AM VOLUNTARILY RELEASING MY DATE OF BIRTH, SOCIAL SECURITY NUMBER, AND OTHER INFORMATION AS MAY BE REQUIRED TO VERIFY IDENTIFICATION AND BACKGROUND INFORMATION. I FULLY UNDERSTAND THIS INFORMATION IS FOR MY BENEFIT IN SEEKING EMPLOYMENT, AND THAT ALL DECISIONS FOR EMPLOYMENT ARE BASED ON LEGITIMATE NON-DISCRIMINATORY BASIS.
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