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Exit Interview
Employee Name
Manager's Name
Start Date
MM slash DD slash YYYY
Date of Separation
MM slash DD slash YYYY
Job Title
Department
Reason for leaving.
Higher Pay
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Conflict with management
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Other
Please choose all that apply.
If "Other" Please describe your reason for leaving.
Workplace Rating (1-Lowest 5-Highest)
New Hire Orientation
1
2
3
4
5
On-Boarding
1
2
3
4
5
Compensation | Pay
1
2
3
4
5
Benefits
1
2
3
4
5
Safety Training
1
2
3
4
5
On-the-Job Safety
1
2
3
4
5
Access to Job Training & Development
1
2
3
4
5
Equipment, tools, and resources to do your job successfully
1
2
3
4
5
Job duties and expectations clearly defined
1
2
3
4
5
Job Satisfaction
1
2
3
4
5
Career Path Opportunities
1
2
3
4
5
Supervision | Management
1
2
3
4
5
Company Leadership
1
2
3
4
5
Company Culture
1
2
3
4
5
Would you consider re-employment with Das-Co Of Idaho in the future?
Yes
No
Additional Comments | Feedback
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Country
Phone
(Required)
Date Available
(Required)
MM slash DD slash YYYY
Desired Wage
(Required)
Location
(Required)
Nampa, Idaho
Twin Falls, Idaho
Pocatello, Idaho
Position Applying For
(Required)
Laborer
Operator
Pipe Layer/Top Hand
Mechanic
PM Mechanic
Welder
Water/Sewer Estimator
Water/Sewer Project Manager
Are You eligible to work in the United States?
(Required)
Yes
No
What US law prohibits your employment?
(Required)
Are you 18 Years of age or older?
(Required)
Yes
No
What is your current age?
(Required)
Have you ever been employed by Das-Co/Bighorn?
(Required)
Yes
No
What were your dates of employment & your reasons for leaving?
(Required)
Do you know any current Das-Co/Bighorn employees?
(Required)
Yes
No
Please provide their name and relation to you.
(Required)
Do you have a valid driver's license?
(Required)
Yes
No
Please provide Class Type, State & License #
(Required)
Have you ever been convicted of a felony?
(Required)
Yes
No
Please provide date & explanation.
(Required)
Name of High School or GED
Completion Date
MM slash DD slash YYYY
Area of Training
Name of Trade School
Completion Date
MM slash DD slash YYYY
Area of Training
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Completion Date
MM slash DD slash YYYY
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Other relevant credentials & licenses.
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Previous Employer #1
Employed From
MM slash DD slash YYYY
Phone
Employed To
MM slash DD slash YYYY
Name & Title of Manager
Starting Base Wage
Your Position
Ending Base Wage
Your Responsibilities
Reason for Leaving
May we contact this reference?
Yes
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Previous Employer #2
Employed From
MM slash DD slash YYYY
Phone
Employed To
MM slash DD slash YYYY
Name & Title of Manager
Starting Base Wage
Your Position
Ending Base Wage
Your Responsibilities
Reason for Leaving
May we contact this reference?
Yes
No
Consent
(Required)
I agree to the privacy policy.
I understand and agree that this application is not a contract and that acceptance of employment is not a contract of employment for a specified term. I understand and agree that I may resign my employment with Das-co of Idaho, Inc or Bighorn Traffic Services (the Company) at any time for any reason, and that my employment may be terminated by the Company at any time for any reason. I also understand that any handbooks, manuals, policies, and procedures maintained by the Company are not contractual in nature, and may be amended or abolished at the sole discretion of the company at any time. I authorize you to make such investigations and inquiries of my personal, employment, financial, or medical histories; and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional employment offer has been extended.) I hereby release employers, schools, health care providers, and other person from any and all liability in responding to inquiries and releasing information in connection with my application. Further, should I become an employee of Das-co of Idaho, Inc, I will abide by the terms of the Company's Employee Handbooks, including Drug policys, Code of Conduct, and Safety Guidelines. I will conduct the Company’s business in a strictly ethical and legal manner. I will, in addition, obey all of the laws of the United States and of all localities and states where the Company does business or seeks to do business. Pursuant to the Immigration Reform and Control Act, the Company employs only those individuals who are eligible to work in the United States. Accordingly, upon hiring and as a new employee, I understand I will be required to demonstrate my eligibility to work in the United States. Failure to do so will result in termination or revocation of the employment offer. I also certify
that the information furnished in this application, and any and all entries and information, were completed by me and that all supporting documents are true and complete to the best of my knowledge and belief, and I understand that any misrepresentation or omission of material fact on this or any other record submitted pertinent to employment will constitute grounds for immediate dismissal.
Das-Co of Idaho, Inc. & Bighorn Traffic Services perform pre-employment drug screenings on all applicants & maintains an ongoing drug and alcohol abuse testing policy. If you are unable to pass the pre-employment screening or unwilling to participate in the ongoing drug and alcohol abuse program you will be disqualified as an applicant.
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Sao Tome and Principe
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Serbia
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Sierra Leone
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Sint Maarten
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Garage Location
Are Existing Utilities On Garage Side?
(Required)
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No
Current Stage of Construction?
What is the estimated BTU load?
(Required)
Standard Meter Location
(Required)
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No
Estimated Ready To Install Date
MM slash DD slash YYYY
Total Square Footage
(Required)
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(Required)
4 Ounces
2 Pounds
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