Full Name *

Current Address *

City *

State *

Zip Code *

County *

Phone *

Email *

Cover Letter

Upload CV/ResumeAllowed Type(s): .pdf, .doc, .docx

Are you legally eligible to work in the United States? *

Yes No

What type of position are you applying for?

What are your wage/salary expectations *

Do you prefer Hourly, Salary or Yearly? *

Hourly Salary Yearly

When would you be able to start working? *

Are you 18 years or older? *

Yes No

In accordance to FMCSR, to operate a Commercial Motor Vehicle (CMV) interstate you need to be at least 21 years old. Only complete if applicable to the job you are applying for. *

Yes No

Have you ever been employed by HL Chapman and/or an affiliate? If so, what company did you work for and what date?

Yes No

If yes, provide details

Do you have any relatives working for HL Chapman and/or an affiliate? If so, who is your relative?

Yes No

If yes, provide details

Do you have a valid driver’s license? As applicable to the job you are applying for. *

Yes No

Have you ever been denied a license, permit, or privilege to operate a motor vehicle as applicable to the position applying for?

Yes No

If yes, give details.

Has any license, permit, or privilege ever been suspended or revoked? As applicable to position applying for.

Yes No

If yes, provide details

Are you willing to participate in a background check upon conditional job offer? *

Yes No

Are you able to perform the essential functions of the job for which you are applying for, with or without reasonable accommodation? *

Yes No

Education History

High School, Location, Years Attended, GED, Diploma or Degree

College or University, Location, Years Attended, GED, Diploma or Degree

Other (Technical, Vocational, Business, etc.), Location, Years Attended, GED, Diploma or Degree

List any achievements, awards, honors, etc.

Employment History

Instructions: Please list your employer(s) for the past three years, listing the most recent employer first. Any gaps in employment and/or unemployment must be explained. If additional space is required, please enter on a separate sheet.
* CDL Drivers: Please list your employers for the past ten years, listing the most recent employer first.
When answering questions A and B, please refer to the following information.
* The Federal Motor Carrier Safety Regulations (FMCSR’s) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weighs or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport 9 or more passengers, OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

Company Name and Position Held *

Work Began *

Work Ended *

Address and Phone Number *

Supervisors Name and Phone Number *

Reason for Leaving *

A. Were you subject to the FMCSR's* while employed: *

Yes No

B. Was your job designated as a Safety-Sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40 *

Yes No

Account for Period between Jobs with Reason (if applicable)

From

To (Current)

Company Name and Position Held

Work Began

Work Ended

Address and Phone Number

Supervisors Name and Phone Number

Reason for Leaving

A. Were you subject to the FMCSRs* while employed?

Yes No

B. Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Yes No

Account for Period between Jobs with Reason (if applicable)

From

To (Current)

Company Name and Position Held

Work Began

Work Ended

Address and Phone Number

Supervisors Name and Phone Number

Reason for Leaving

A. Were you subject to the FMCSRs* while employed?

Yes No

B. Was your job designated as a safety-sensitive function in any DOT-regulated mode subject to the drug and alcohol testing requirements of 49 CFR Part 40?

Yes No

Account for Period between Jobs with Reason (if applicable)

From

To (Current)

References

If you did not provide work references in your employment history, please provide a reference who has knowledge of your occupational skills and background.

Name, Phone Number, Occupation and Length of time known *

Which location do you prefer to work? *

Austin San Antonio Out of Town Traveling

Are you able / willing to travel out of state for the position applied for? *

Yes No

Employment Statement

An Equal Opportunity Employer
HL Chapman and/or affiliates, provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HL Chapman and/or affiliates complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.

Please read the following statement before signing.
I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

• Review information provided by current/previous employers:
• Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.”

I understand that the hiring process may require interviews, written tests and job demonstrations. I agree that I will state whether I need any reasonable accommodations for the job selection procedures.

I understand and agree that I will participate in a Drug and Alcohol test and a physical examination if a job offer is made and that my employment is contingent on satisfactory completion of the test and the examination.

Furthermore, I understand that misrepresentation or omission of requested information may result in my disqualification of employment or dismissal from employment process.

This application is not an employment contract. Any offer of employment will be on an employment-at-will-basis. This means that I will not have an express or implied employment contract and that both the employer and I will have the right to terminate my employment at any time and for any reason.

My signature certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Full Name *

Date: *

Signature: Please type your name *

EEO: Affirmative Action Self-Identifier Form

We are Equal Opportunity Employer. As required by law, we must record certain information as part of our Affirmative Action Program. Applicants for employment are invited to complete this informational form. You are advised that (a) you are under no obligation to respond but may do so in the future, (b) responses will remain confidential, and (c) responses are only used to provide necessary information included in Affirmative Action reporting. Refusal to provide this i1?formation will have no effect on your application.for employment.

Personal Information

Name

Position applying for:

Application Date:

Ethnicity

Please check all that apply

Ethnicity

White (not Hispanic or Latino). Persons having origins in any of the original peoples of Europe or North Africa or the Middle East. Black or African American (not Hispanic or Latino). Persons having origins in any of the black racial groups of Africa. American Indian or Alaskan Native (not Hispanic or Latino). Persons having origins in any of the original peoples of North and South America. including Central America who maintain tribal affiliation or community. Asian (not Hispanic or Latino). Chinese/Chinese-American: Persons having origins in any of the original peoples of China. Japanese/JapaneseAmerican: Persons having origins in any of the original peoples of Japa/ Filipino/Pilipino: Persons having origins in any of the original people of the Philippine Islands. Pakistani/East Indian: Persons having origins in any of the original peoples of the Indian subcontinent (e.g. India and Pakistan). Other Asian: Persons having origins in any of the original peoples of the Far East (including Korea. Malaysia. Cambodia. Thailand and Vietnam) and Southeast Asia. Native Hawaiian or Other Pacific Islander (not Hispanic or Latino). Persons having origins in any of the original peoples of Hawaii. Guam Samoa. or other Pacific Islands. Hispanic or Latino (including Black individuals whose origins are Hispanic). Mexican/Mexican-American/Chicano: Persons of the Mexican culture or origin. regardless of race. Latin-American/Latino: Persons of Latin America (e.g. Central American South American. Cuban. Puerto Rican) culture of origin. regardless of race. Other Spanish/SpanishAmerican: Persons of Spanish culture or origin. not included in any of the Hispanic categories listed above. Multi-Racial..Persons who identify with more than one of the above races/ethnicities. l choose not to answer

Gender

Male Female I choose not to answer

Veteran Status

Vietnam Era Veteran Other eligible Veteran Special Disabled Veteran I choose not to answer

This EEO form is to be kept in a local file that is separate from the employment application.

By using this form you agree with the storage and handling of your data by this website. *

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H.L. Chapman Pipeline Construction, Inc. specializes in mass rock excavation and custom trenching. Chapman became the industry leader by pioneering techniques and developing machines to successfully excavate mass rock and trench for utility, pipeline and communication lines.

About H.L. Chapman

The largest trenching and mass rock excavation company in the world.

Our Work

Specialized trenching services since 1974.

Safety

Experience and trained personnel and the right equipment

Support

Experience and trained personnel and the right equipment

Careers

Contact

9250 F.M. 2243, Leander, TX 78641
Phone: (512) 259-7662
Fax: (512)259-7870
Email: [email protected]

Parts Runner / Warehouse Associate

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Education History

Employment History

References

Employment Statement

EEO: Affirmative Action Self-Identifier Form

Personal Information

Ethnicity

Gender

Veteran Status

This EEO form is to be kept in a local file that is separate from the employment application.