Fill Out Completely And Accurately

"An Equal Opportunity Employer"

  BSP Application For Employment Online Form  
  We appreciate your interest in our organization and we are sincerely interested in your qualifications. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization. All employment offers are conditional pending results of a pre-employment drug screen and background check.  
PERSONAL INFORMATION Fields Marked With * Are Mandatory
Street *
City *
State *
Zip *
Position(s) you are applying for *
Age (If under 21) *
Have you previously applied or worked for Border States Paving?
If yes, provide dates
Have you ever served in the military? *
Branch of service
Rank at discharge
Length of service
If yes, describe in full
(Conviction of a felony does not automatically bar employment, circumstances will be considered)
If hired, can you provide proof that you can legally work in the United States? *
(Proof of eligibility will be required upon employment)
List any friends or relatives other than spouse, currently employed at Border States Paving *
  Number of Years Completed * Degrees Earned or Expected * Major Course of Study *
How did you learn about our available position(s)? *
Any restrictions on days/hours/weekends? *
Are you willing to travel if required? *
Are there specific days/hours that you cannot work? *
Truck Driver Experience *
Equipment Operator Experience *
Other Relevant Experience OR Special Training *
Include the last 7 years of your employment history
Current or Last Employer:
Name of Current or Last Employer *
Phone Number *
Street Address *
City *
State *
Zip *
Position Held *
From *(Month/Year)
To *(Month/Year)
Supervisor's Name and Phone Number *
Describe the work you did *
Reason for leaving *
Second Last Employer:
Name of Current or Last Employer
Phone Number
Street Address
Position Held
From (Month/Year)
To (Month/Year)
Supervisor's Name and Phone Number
Describe the work you did
Reason for leaving
Third Last Employer:
Name of Current or Last Employer
Phone Number
Street Address
Position Held
From (Month/Year)
To (Month/Year)
Supervisor's Name and Phone Number
Describe the work you did
Reason for leaving

I voluntarily give Border States Paving, Inc. the right to make a thorough investigation of my past employment and activities, and release from all liability all persons or companies supplying such information.

I authorize investigation of all statements contained in this application, and agree that if any misrepresentation has been made by me herein or the results of an investigation are not satisfactory for any reason, any offer of employment made of me by the company may be terminated immediately without any obligation or liability to me other than for payment, at the rate agreed upon, for services actually rendered if I have been employed.

I understand that false, misleading or incomplete information given in my application or interview(s) shall be sufficient grounds for disqualification of this application or termination of employment, if this application results in employment. I understand that I have the right to terminate my employment at any time, for any reason, and the company retains a similar right, if an employment relationship is established.

This 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. Any false, misleading or incomplete statements of the information requested in this application and any supplemental material submitted after shall be sufficient grounds for disqualification of my application or termination of employment, if my application results in employment.


Border States Paving, Inc. is committed to employing the most qualified applicants for available positions, regardless of race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status or veteran status. In conjunction with that commitment, we have an Affirmative Action plan which is intended to encourage qualified women, veterans, minorities, and individuals with disabilities to apply for open positions. While special effort is made to encourage these individuals to apply, all candidates are considered equally once they have applied.

To determine whether we have met our goals for encouraging women, minorities, veterans, and disabled individuals to apply, we need to gather related information from all our applicants. Please consider providing us with the information requested below. Your participation is optional and your decision to provide or not to provide the information will in no way impact your consideration for the position. Furthermore, the information you provide will not be seen by the individuals evaluating your qualifications and determining whether or not you will be offered a position.

First Name
Last Name
Date (D/M/Y)
What position are you applying for?
How did you hear about this position?
(Select the most appropriate option
and provide source name if requested)
Friend or Family  
Career Fair
(Select the most appropriate box
to indicate your gender)
(Select the option that you
most closely identify with)
American Indian or Alaskan Native
Persons having origins in any of the original peoples of North, Central, or South America and who maintain tribal affiliation or community attachment.
Asian or Pacific Islander
Persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands.
Black/African-American (not of Hispanic origin)
Persons having origins in any of the Black racial groups of Africa.
Hispanic or Latino
Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.
Mixed Race
Persons having origins in multiple races.
White (not Hispanic origin)
Persons having origins in any of the original peoples of Europe, the Middle East, or North Africa.
(Do you consider yourself
as in any way disabled?)
Veteran Status
(Select the most appropriate box
to indicate your status)
Voluntary Self-Identification of Disability Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2017

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

• Blindness
• Deafness
• Cancer
• Diabetes
• Epilepsy
• Autism
  • Cerebral palsy
• Schizophrenia
• Muscular dystrophy
• Bipolar disorder
• Major depression
  • Multiple sclerosis (MS)
• Missing limbs or partially missing limbs
• Post-traumatic stress disorder (PTSD)
• Obsessive compulsive disorder
• Impairments requiring the use of a wheelchair
• Intellectual disability (previously called mental retardation)
Please check one of the options below:
YES, I HAVE A DISABILITY (or previously had a disability)
Your Name   Today's Date (D/M/Y)
Border States Paving, Inc.
Human Resources
4101 32nd St. N. - P.O Box 2586
Fargo, ND 58108
Ph 701-237-4860
Fax 701-237-0233