Job Application

You may fill out the PDF format and email it to: Employment@gcli.com

Fill out the form below to submit your application electronically.

Employment Application

*Do not use the Back or Refresh buttons during this process or you will lose everything you have done. Fill out the entire form and hit "Submit" at the bottom of the page. Gulf Coast Limestone, Inc. is an Equal Opportunity Employer

Name*
PrefixFirstLastSuffix
Email
Drivers License #*
Address*
Street AddressCityState / Province / RegionZip / Postal Code
Phone*
Social Security Number*
Position(s) Applied For*
- First Choice
- Second Choice
- Third Choice
Date of Application*
Referral Source
If you are under 18, can you furnish a work permit?*
- Yes
- No
Have you filed an application with us before?*
- Yes
- No
Have you ever been employed with GCLI?*
- Yes
- No
If Yes, give the date
Are you legally eligible for employment in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment)*
- Yes
- No
Type of employment desired?*
- Full Time
- Part Time
- Temporary
Are you on layoff and subject to recall?*
- Yes
- No
Will you relocate if the job requires it?*
- Yes
- No
Will you travel if the job requires it?*
- Yes
- No
Are you able to meet the attendance requirements of the position?*
- Yes
- No
Will you work overtime if required?*
- Yes
- No
Have you ever been bonded?*
- Yes
- No
Have you been convicted of a felony in the last (7) years? (Such convictions may be relevant if job related, but does not bar you from employment)*
- Yes
- No
If yes, please explain:
Resume (if applicable)
Employment History
List your last (4) employers assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comments section below.
(1) Employer
Phone
Address
Street AddressCityStateZip Code
Job Title
Immediate Supervisor
Dates Employed: From
Dates Employed: To
Summarize the nature of the work performed and job responsibilities.
Reason for leaving:
Hourly Rate / Salary Starting:
Hourly Rate / Salary Final:
May we contact for reference?
- Yes
- No
(2) Employer
Phone
Address
Street AddressCityStateZip Code
Job Title
Immediate Supervisor
Dates Employed From:
Dates Employed To:
Summarize the nature of the work performed and job responsibilities.
Reason for leaving:
Hourly Rate / Salary Starting:
Hourly Rate / Salary Final:
May we contact for reference?
- Yes
- No
(3) Employer
Phone
Address
Street AddressCityState / Province / RegionZip / Postal Code
Job Title
Immediate Supervisor
Dates Employed From:
Dates Employed To:
Summarize the nature of the work performed and job responsibilities.
Reason for leaving:
Hourly Rate / Salary Starting:
Hourly Rate / Salary Final
May we contact for reference?*
- Yes
- No
Comments (Including explanation of any gaps in employment)
Skills and Qualifications: (Summarize special skills and qualifications acquired from employment or any other experiences that may qualify you to work with our company)
Educational Background
List the last (3) schools attended, starting with the last one.
(1) School
Years Completed
Degree / Diploma
GPA / Class Rank
Major
Minor
(2) School
Years Completed
Degree / Diploma
GPA / Class Rank
Major
Minor
(3) School
Years Competed
Degree / Diploma
GPA / Class Rank
Major
Minor
References
List name & phone of three business/work references who are not related to you. If not applicable, list three school or personal references that are not related to you.
(1) Name
FirstLast
Phone
Years Known
(2) Name
FirstLast
Phone
Years Known
(3) Name
FirstLast
Phone
Years Known
List professional, trade, business, or civic associations and any offices held.
List special accomplishments, publications, awards. (Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or other protected status.)
List any additional information you would like us to consider.
Please Read Before Submitting:
It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or seperation from the employer's service if I have been employed. I give Employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability Gulf Coast Limestone, Inc. and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. Gulf Coast Limestone, Inc. is an equal opportunity employer. The employer does not descriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state of federal law. This application is current for only 60 days. At the conclusion of this time, if you have not heard from the Employer and still wish to be considered for employment it will be necessary to fill out the application. I understand that just as I am free to resign at any time, GCLI reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the employer has the authority to make any assurance to the contrary. By completing and submitting this application for employment, I understand and agree that Gulf Coast Limestone, Inc. has a dispute resolution plan, which is incorporated by reference in this application. This is the required and exclusive way for applicants, employees and the Company to resolve any and all disputes. I agree to resolve any disputes between the GCLI and me arising out of the application or, if the company hires me, out of my employment, through the Dispute Resolution Plan, which includes binding arbitration as a final step.
By Checking this box you agree that you have read and agree with the statement above, and that all information on this application is true.*
- I agree
Name*
FirstLast
Date*