Applicants Name


    Phone Number:

    Email Address


    1. Position applying for? Laborer/Concrete Tech/Journeyman Concrete Tech/Concrete Tech that can weld/Other

    2. Have you read the job description?

    3. Can and will you be able to fulfill the duties of this job description?

    4. Have you completed an application?

    5. Do you live in the area of the open position?

    6. Where did you hear about Restruction Corporation?

    7. (Welders Only) If you are a welder can you pass a stick certification test?

    8. List skills, degrees and or certifications:

    9. Are you currently employed?

    10. When required can and will you work nights?

    11. When required can and will you work weekends?

    12. When required can and will you work out of town?

    13. When required can and will you work jobs with heights?

    14. Can and will you work overtime or past the scheduled end of your shift when the job requires it?

    15. Do you have a current driver’s license and clean DMV record?

    16. Do you have transportation?

    17. Rate safety from 1 to 10 with 10 being the highest.

    18. Have you been dishonorably discharged from the military, fired or quit to avoid being fired?

    19. Have you been convicted of any law violation including plea of guilty or no contest?
    (Exclude minor traffic violations)

    If you answered yes on either of the two previous questions please explain and provide when they occurred.

    20. Unless you’re hired for a management position you will be part of the work force on a job. This means regardless of your field position/title including welders your duties may include but are not limited to jack hammering, digging a ditch, mucking concrete etc. Are you capable and willing to do this or whatever may be required?

    21. Prior to employment we conduct a pre-employment physical since physical labor is required for all field positions. The physical will be lifting, bending, squeezing, squatting, turning, etc. Although this may not disqualify you for employment do you have limitations that would cause concern for this evaluation?

    22. Some jobs require the use of a respirator. If facial hair interferes with the respirator seal it is an OSHA violation. A mustache or small goatee is acceptable as long as it does not interfere with the seal of the respirator. So you must be willing to shave when wearing a respirator on the job. If you cannot shave for any reason let your interviewer know. You will also need to be shaved for safety orientation at which point a respirator fit test will be performed. Can you comply with this shaving requirement?

    If you can’t shave please provide reason

    23. What is your desired hourly wage with Restruciton Corporation?

    24. What was (or is) your hourly wage at your most recent job?

    25. Do you need a translator for your in person interview?

    26. Can we contact your references and listed employers?
    Reminder: add back sheet if not included.

    Applicant Signature confirming answers:

    Translator Signature if applicable:

    In person or virtual interviewer:


    Use assessment interview questionnaire to assist in this interview