The Company does not discriminate against any employee or applicant for employment because of race, color, creed, religion, ancestry, national origin, sex, affectional preference, disability, genetic testing, age (except as required by law), marital status or status with regards to public assistance. Individuals will not be excluded from employment rights, participation in or be denied the benefits of, or be otherwise subjected to discrimination under any program, service or activity under the provisions of any and all applicable federal, state, and local laws against discrimination.

Company prohibits the harassment of any employee or job applicant.

Job Title

Which job are you applying for? *

Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

Are you legally authorized to work in the United States? *

Yes

No

Where did you originally find out about this job? *

Which of the following best represents your racial or ethnic heritage? Choose all that apply.

Employee Referral *

Other *

Do you have reliable transportation? *

Yes

No

Experience

How many years of experience do you have in this position? *

Rate your experience in this position from 1 to 10 (1 no experience to 10 expert experience) *

Education

High school last attended

Number of years completed

Graduate

Yes

No

Degree, diploma or certificate, and area of study

Vocational, technical school

Number of years completed

Graduate

Yes

No

Degree, diploma or certificate, and area of study

College or university

Number of years completed

Graduate

Yes

No

Degree, diploma or certificate, and area of study

Other

Number of years completed

Graduate

Yes

No

Degree, diploma or certificate, and area of study

Employment History

Employer 1

Company Name *

Address *

Phone *

Position *

Salary *

Start Date +

End Date +

Supervisor/Manager *

Phone Number *

Reason for Leaving *

Employer 2

Company Name

Address

Phone

Position

Salary

Start Date +

End Date +

Supervisor/Manager

Phone Number

Reason for Leaving

Employer 3

Company Name

Address

Phone

Position

Salary

Start Date +

End Date +

Supervisor/Manager

Phone Number

Reason for Leaving

Have you ever been discharged by an employer *

Yes

No

If yes, please explain

Current Employment

Are you currently working? *

Yes

No

What is the name of your current company? *

How long have you been employed with your current company? *

Who was your most recent previous employer? *

How long did were you employed with them for? *

What was your reason for leaving? *

Is this job commercial or residential? (Please provide a percentage breakdown if you did both? Such as: 50% residential, 50% commercial) *

Is this job union or non-union? *

Please list your daily duties from your most recent position: *

0/255 characters

Why are you looking for a new job? *

0/255 characters

References

List three references that you are not related to, whom you’ve know more than one year.

*By providing references, you are allowing us to reach out and contact them.

Reference 1

Name *

Title *

Email Address *

Phone *

Reference 2

Name

Title

Email Address

Phone

Reference 3

Name

Title

Email Address

Phone

May we contact these references?

Yes

No

Additional Skills

List any additional skills that you would like to mention.

Please submit a copy of your resume.

Acknowledgement and Signature

The Company has policies on sexual harassment and equal opportunity, policies which require employees to perform all assigned work and necessary overtime, policies requiring wage or salary deduction authorizations by employees for company property, debts or moneys not returned or repaid, an at-will employment policy, solicitation and distribution policies, and policies requiring employees to observe all standards of conduct, and policies of Company.

ACKNOWLEDGEMENT: PLEASE READ AND SIGN (if you agree)
By my signature below, I promise that the information provided in this employment application (and in any related documentation or interview) is true and complete, and I understand that any false or misleading information or significant omissions may disqualify me from further consideration for employment, and may lead to my dismissal from employment, if discovered at a later date.

I authorize any person, school, current or prior employer named in this form (or related documents or interview) to provide Company with any information and opinion requested by Company in connection with my application, and I release such persons, employers, and schools from any liability in making such statements.

I understand if I am selected for an interview or given a conditional offer of employment, the company may ask me if I have been convicted of a misdemeanor, a felony or convicted in a military court martial and, if yes, ask me to provide information regarding the same. I understand the company may consider this information in connection with deciding whether to hire me in accordance with applicable law. (A conviction will not necessarily disqualify you from employment.)

I understand that this application does not create a contract of employment. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted Company policies. I understand and agree that, if hired, my employment is at-will and is for no definite period of time, and may, regardless of the date of payment of wages or salary, be terminated at any time for any reason.

Please type your first and last name to acknowledge and agree with the above *

Date +

Non-Hispanic White or Euro-American	Black, Afro-Caribbean, or African American
Latino or Hispanic American	East Asian or Asian American
South Asian or Indian American	Middle Eastern or Arab American
Native American or Alaskan Native	Other
Decline to answer