JD's Rebar & Construction, Inc. | 1348 Rapides Ave. | Alexandria, LA. 71301
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We spend a lot of time and energy making your project a success.

 

Employee


Your Project + Our Passion = Success

Equal Opportunity Employer

Employment opportunities at J.D.'s Rebar & Construction are open to all qualified applicants solely on the basis of their job-related experience, knowledge, skills, and abilities.

Qualified applicants are considered for all open positions for which they apply and for advancement without regard to race, color, religion, sex, sexual orientation, national origin, age, marital status, the presence of a medical condition or disability, or genetic information. J.D.'s Rebar & Construction complies with all applicable federal, state and local laws with regard to equal employment opportunity. Advancement is based entirely on an individual's demonstrated performance, job-related ability, skills, and knowledge and the resulting potential for promotion to the job openings applied for.

J.D.'s Rebar & Construction will not tolerate discrimination, harassment, or retaliation affecting its employees or applicants due to race, color, religion, sex, sexual orientation, national origin, age, marital status, medical condition, disability, genetic information, or any other category protected under the law.

JD's REBAR AND CONSTRUCTION, INC Application For Employment PRE-EMPLOYMENT QUESTIONNAIRE EQUAL OPPORTUNITY EMPLOYER
PERSONAL INFORMATION
DATE 08/21/2017
Name*
(Last Name, First Name)
Email*
 
Social Security Number
PRESENT ADDRESS
 
City
State
Zip Code
 
MAILING ADDRESS
 
City
State
Zip Code
 
Phone Number
 
Referred By
EMPLOYMENT DESIRED
Position:
 
Date You Can Start:
Salary Desired: $
Ever Applied Before When:
 
Currently Employed:
If So May We Contact: Yes No
 
Skills
Any Special Skills Which Qualify You For This Position
Us Military Service
Yes No
 
Rank
FORMER EMPLOYERS
DATE MO/YR
NAME & ADDRESS
SALARY
POSITION
REASON FOR LEAVING
From
To
$
From
To
$
From
To
$
Add More

Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on the application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release of use of disability-related medical information in manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

Date :
SIGNATURE*:

Background History

A “yes” response will not automatically disqualify you from employment, but will be considered. You do not need to disclose any information that has been expunged from your records.

Have you ever been convicted of a felony? If yes please explain
Yes No
Have you ever been convicted of a violent crime? If yes please explain
Yes No
Have you ever been convicted of a misdemeanor? If yes please explain
Yes No
Are you currently on probation or parole? If yes please explain
Yes No
Have you spent any time in any correctional facility? If yes please explain
Yes No
Have you ever received a DWI/DUI? If yes how many
Have you ever been on probation or parole? If yes explain
Yes No

All untruthfulness will result in immediate termination.

JD's Rebar & Construction, Inc.

JD'S REBAR AND CONSTRUCTION, INC
MEDICAL QUESTIONNAlRE

YOUR FAILURE TO ANSWER ANY OF THE QUESTIONS ON THIS FORM TRUTHFULLY MAY RESULT IN YOUR FORFEIT OF WORKERS COMPENSATION BENEFITS UNDER LA R.S. 23:1205.1
Indicate whether or not you currently have, have previously had, or have ever been treated for any of the following conditions. (Check box to indicate “YES”)
EPILEPSY DIABETES
HEART DISEASE ARTHRITIS
AMPUTATION OR LOSS OF USE OF FOOT, LEG, ARM OR HAND ANY LOSS OF SIGHT
DOUBLE OR BLURRED VISION POLIO
CEREBRAL PALSY MULTIPLE SCLEROSIS
PARKlNSON'S DISEASE STROKE
TUBERCULOSIS SILICOSIS
ASBESTOSIS MENTAL ILLNESS
HEMOPHILIA OSTEOMYELITIS
HEAD INJURY ANKYLOSIS OF JOINTS
HYPERINSULINISM MUSCULAR DYSTROPHY
ARTERIOSCLEROSIS FRACTURED/BROKEN BONE
VARICOSE VEINS HEAVY METAL POISONING
BRAIN DAMAGE SPINAL FUSION OR SURGICAL
REMOVAL OF INTERVERTEBRAL NERVOUS BREAKDOWN
IONIZING RADIATION COMPRESSED AIR SEQUELAE
BRONCHITUS EMPHYSEMA
ASTHMA RUPTURED OR BULGING INTEV DISC
HODGKINS DISEASE MENTAL RETARDATION
CARPAL TUNNEL SYNDROME HYPERTENSION
HIGH BLOOD PRESSURE ROTATOR CUFF INJURY
KNEE, NECK, BACK INJURY OTHER INJURY
THROMBOPHLEBITIS  
If you checked any of the above, please explain in detail on the bottom of this form the nature of your injury or condition, the type of treatment received, the date of last treatment and the name and address of treating doctor.
Are you presently under any medical treatment?. If so, please describe the condition being treated and the name and address of person treating you.
Yes No
Are you presently taking medication? . If so, please name the medication, the medical condition being treated and the name and address of person prescribing the medication. Yes No
Have you ever had surgery? . If so, please list the part of the body that was operated on, the type of operation, the date of the operation and the name and address of the physician. Yes No
Are you presently under any medical therapy?.If so, please describe the condition being treated and the name and address of person treating you .
Yes No
Have you ever had an injury which required you to miss time from work?.If so, please describe the type of injury, the amount of time missed from work, the name and address of your employer, whether the condition of fully healed or whether it left you with any impairment and whether you returned to work?
Yes No
Has a doctor ever restricted your activities? If so, please describe the medical condition requiring the restriction, whether these restrictions where permanent or temporary and whether you are under these restrictions now? Yes No
WARNING: PURSUANT TOLSA:1203.1. I UNDERSTAND THAT THE FAILURE TO ANSWER ANY OF THESE QUESTIONS TRUTHFULLY MAY RESULT IN THE DENIAL OF ANY RIGHT I OR MY DEPENDANTS MAY HAVE TO WORKERS COMPENSATION BENEFITS. INCLUDING WEEKLY BENEFITS, MEDICAL TREATMENTS AND EXPENSES, UNDER R.S.23.1203.1
I HAVE READ AND UNDERSTOOD THE MEDICAL QUESTIONNAIRE. I HAVE ALSO REVIEWED THE ANSWERS TO THE MEDICAL QUESTIONNAIRE AND THEY ARE ACCURATE.
APPLICANT SIGNATURE*:
Date :
 
Security Code*:
Note: Security Code is case sensitive
           
 
About Us
Tradition has been passed down from generation to generation. And, although JD's name is not well-known, we bring quality to the rebar construction industry. We've seen all aspects of the industry and will continue to strive for excellence. read more
 
Testimonials
"Great job...JD's finished way ahead of..."
- John - Project Manager
"The team that was assigned to our project...was extremely professional throughout the project and our expectations were met and often exceeded. We look forward to working with JD's Rebar..."
- W. Mullins
 
           
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