Test Job Application (Simplified) "*" indicates required fields Step 1 of 5 20% Name* First Last Date of Application* MM slash DD slash YYYY Present Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Telephone Number*Are You 18 Years of Age?* Yes No Position Desired Background InformationHave you ever been terminated or asked to resign from any job?* No Yes If yes, please explain:* Have you ever worked for Allegiance Crane & Equipment Crane & Equipment before?* Yes No If yes, please give dates and position:* Do you have any friends or relatives working here or for one of our other companies?* Yes No How did you hear about this job opportunity? Education HistorySchool Information*School NameYears CompletedDiploma/DegreeTraining/Experience Add RemovePlease list High School, College/University, Graduate/Professional, and Trade/Correspondence SchoolsList other qualifications, experiences, licenses, certifications, etc., that you consider pertinent to the job applied for:Do you have a current valid driver’s license?* Yes No Do you have a (CDL) Commercial Driver License?* Yes No Has your license been suspended or revoked?* Yes No If yes, explain: Employment History: Previous Employer #1Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneJob Title(s) Reason for LeavingEmployment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Final Base Salary Employment History: Previous Employer #2Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneJob Title(s) Reason for LeavingEmployment Start Date MM slash DD slash YYYY Employment End Date MM slash DD slash YYYY Final Base Salary Licenses and Operation ExperienceCrane Operator or Rigger Certification(s)Issuing AgencyCertification #DesignationsExpiration Date Add RemoveBoom Truck ExperienceType of EquipmentDates OperatedAprox # of Hours Operated Add RemoveHydraulic Crane ExperienceType of EquipmentDates OperatedAprox # of Hours Operated Add RemoveTower Crane ExperienceType of EquipmentDates OperatedAprox # of Hours Operated Add RemoveOther ExperienceType of EquipmentDates OperatedAprox # of Hours Operated Add RemoveACKNOWLEDGEMENT “By executing and submitting this application, I certify that I am genuinely interested in working in the position(s) for which I have applied and am making this application for no other purpose.” "I hereby certify that the answers given above are true and correct. I understand that any misrepresentation in this application or in any other document submitted to Allegiance Crane & Equipment is sufficient grounds for disqualification of the applicant or, if discovered after the applicant is hired, for discharge. I hereby grant Allegiance Crane & Equipment permission to investigate information included in this application. I agree, as part of the employment process, that any offer of employment extended by Allegiance Crane & Equipment is subject to successfully passing a drug/alcohol screen which may include blood testing, urinalysis, etc. for the purpose of detecting alcohol, drugs, or substances of abuse. I further agree after employment to submit to a medical examination and/or a drug screen when requested by Allegiance Crane & Equipment in accordance with company policies." "In connection with the processing of this application, Allegiance Crane & Equipment and/or their agents, may contact my current and former employers, my listed references, and my schools to obtain more information about me and I authorize and release from all liability those persons to give Allegiance Crane & Equipment any information regarding my employment, character, safety performance (as required by 49 CFR 391.23[d] and [e]), and qualifications, together with any information they may have regarding me whether or not it is in their records. Allegiance Crane & Equipment may also contact any investigative, criminal, credit or consumer reporting agency to obtain information concerning my character, general reputation, personal characteristics, and mode of living. I understand that all offers of employment extended by Allegiance Crane & Equipment are subject to investigations described above, and that such investigations may not be completed until after I am hired. Should employment be denied or terminated, either wholly or partly, because of information obtained from this report before or after I am hired, Allegiance Crane & Equipment will advise me of that fact and provide the name and address of the investigative, credit or consumer reporting agency making the report. " "If hired by Allegiance Crane & Equipment, I agree that all right, title and interest, including, without limitation, all copyrights and patents, in and to any intellectual property produced or inventions developed by me which affect or relate to Allegiance Crane & Equipment’s business or affect or relate to the crane industry shall vest in Allegiance Crane & Equipment and I shall have no personal right, title or interest whatsoever therein." "I understand and agree that, if hired by Allegiance Crane & Equipment, I will be subject to Allegiance Crane & Equipment’s employment policies, as may be amended from time-to-time by Allegiance Crane & Equipment, in its sole discretion. I further agree to keep confidential all information I may be exposed to or come to learn as a result of any employment with Allegiance Crane & Equipment." "I understand that, any employee hired by Allegiance Crane & Equipment is hired as an employee-at-will who may be terminated without cause or notice at any time, except for those employees covered by collective bargaining agreements, at the sole option of Allegiance Crane & Equipment. No one at Allegiance Crane & Equipment has the authority to change such an employment-at-will relationship."