• WINGRA STONE COMPANY608-271-5555
  • WINGRA REDI-MIX, INC.608-271-9388
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  • Application For Employment

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  • WINGRA

    Update any changes to the information below to the office as they occur.

    Fields marked with an asterisk (*) are required.

  • Application for:

    Wingra Redi-Mix, Inc. & Wingra Stone Company P.O. Box 44284 Madison, WI 53744-4284
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  • First
  • Middle
  • Last
  • Previous 3 Years of Residency

  • Emergency Contacts

  • If you hold a Commerical Driver's License (CDL) fully complete this section - do not leave any blanks. If you do not hold a CDL, skip this section.

    No person who operates a commerical motor vehicle shall at any time have more than one driver's license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years.
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  • Employment Record - Include the previous 10 years including years of self-employment

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  • Education

    Only list the highest level of schooling completed
  • Driving and Equipment Operation Record

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  • List all Motor Vehicle Accidents you have been involved in for the past 3 years

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  • List all Motor Vehicle Violations (other than parking tickets) for the past 3 years

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  • Max. file size: 20 MB.
  • Voluntary Information

    As an employer with an Affirmative Action Program, we comply with government regulations, including Affirmative Action Responsibilities where they apply. In an attempt to judge the effectiveness of our recruitment efforts, we request that you provide the following information. This information, will in no way, be used in the decision to hire or promote.

  • "Qualified individuals with disabilities, shall not solely by reason of their disability be excluded from participation in, or be denied the benefits of, or be subjected to discriminaion under any program or activity." (Section 504 of the Rehabilitation act of 1973 29 U.S.0 706 ) (8), 794. In accordance with proceeding and Section 1630.4 EEOC Americans with Disabilities Act Employment Regulations. WINGRA invites applicants for employment to indicate whether they are disabled and to what extent, they are disabled. The following information is intended for employment record processing purposes only and should only be provided to WINGRA on a voluntary basis. This information will be kept in strict confidence and will be used in accordance with the applicable laws. Refusal to provide the information on this page will not subject you to any adverse treatment.

  • In accordance with EEOC Americans with Disabilities Act Regulations, 1630.2 (g) and Section 504 of the Rehabilitation Act of 1973, a "Disabled Person" is defined as any person who:

    • 1. Has a physical or mental impairment which substantially limits one or more major life activities.

    • 2. Has a record of such and impairment.

    • 3. Is regarded as having such an impairment.

  • To Be Read and Signed by Applicant

    I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company. I understand that the information I provide regarding my current and/or prior 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. 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 resend 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.
  • This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.

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