JOB APPLICATION FORM

Job Title *

Job Title

Plumber
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Date Applied *

ARE YOU APPLYING AS A CONTRACTOR OR EMPLOYEE?*

Are You Applying As A Contractor or Employee? *

Are You Applying As A Contractor or Employee?

Contractor
Employee
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PERSONAL INFORMATION

First Name *

Last Name *

Email *

Phone *

Present Address *

City *

State *

Postal code *

Are You At Least 18 Years Old? *

Yes

No

If Not, Please State Your Age

Are You Able to Provide Documentation of Your Eligibility for Employment in the US? *

Yes

No

CONTRACTOR INFO

Please Upload a W9

Please Upload a W9

Please Upload General Liability

Please Upload General Liability

Please Upload Workers Comp

Please Upload Workers Comp

Please Upload Proof of Insurance

Please Upload Proof of Insurance

Please Upload Photos of Your Work (select up to 10)

Please Upload Photos of Your Work (select up to 10)

How Many Years of Experience Do You Have?

Do You Have Residential Experience?

Do You Have Residential Experience?

Yes
No
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Do You Have Commercial Experience?

Do You Have Commercial Experience?

Yes
No
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Do You Guarantee Your Work?

Do You Guarantee Your Work?

Yes
No
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If You Guarantee Your Work, For How Long?

IF YOU HAVE A RESUME YOU MAY UPLOAD IT HERE

Attach Your Resume

Upload Resume

EMPLOYMENT INFORMATION

Date Available to Start *

Salary Desired *

Are You Willing to Work Overtime, if Required? *

Yes

No

Are There Any Shifts or Hours Which You Cannot Work? *

Yes

No

If Yes, Please Identify Hours:

Have You Ever Applied For a Position With This Company Before? *

Yes

No

If Yes, When?

Are You Able to Perform the Essential Functions of the Job For Which You are Applying With or Without Accomodation? *

Yes

No

If No, Please Explain What Accommodations You Will Require

Are You Presently Employed?

Yes

No

If Yes, May We Contact Your Present Employer?

Yes

No

Have You Ever Been Convicted of Any Crime Other Than a Minor Traffic Violation? *

Yes

No

If Yes, Please Briefly Describe the Nature of the Crime(s), the Date and Place of Conviction and the Legal Disposition of the Case. This company will not deny employment to any applicant solely because the person has been convicted of a crime. The company however, may consider the nature, date and circumstances of the offense as well whether the offense is relevant to the duties for which a candidate is applying.

Have You Ever Taken Any Illegal Drugs in the Past Thirty (30) Days *

Yes

No

EDUCATION

High School

Name and Location of High School

Years High School Completed

Did You Graduate High School?

Yes

No

College

Name and Location of College Attended

Years Completed - College

Did You Graduate College?

Yes

No

College Degree Earned

Graduate School

Name of Graduate School Attended

Years Completed - Graduate School

Did You Graduate?

Yes

No

Degree Earned

Trade, Business or Certificates

Name and Location of School

Years Completed

Certificate Earned

List Any Other Skills That Would enhance Your Ability to Perform This Position

EMPLOYMENT EXPERIENCE

Please give accurate and complete full and part-time employment record. Start with you present or most recent employer. Account for all periods of time, including military service and any periods of unemploymnet. PLEASE GIVE MONTH AND YEAR

1. Company Name

1. Phone Number

1. Employment Period

1. Address

1. Name of Supervisor

1. Salary/Wages Start

1. State Job Title and Responsibilities

1. Reason for Separation

1. Salary/Wages Finish

1. May We Contact?

Yes

No

1. If No, Please Indicate Reason

2. If No, Please Indicate Reason

2. Company Name

2. Phone Number

2. Address

2. Employment Period

2. Name of Supervisor

2. Salary/Wages Start

2. Salary/Wages Finish

2. State Job Title and Responsibilities

2. Reason for Separation

2. May We Contact?

Yes

No

3. Company Name

3. Phone Number

3. Address

3. Employment Period

3. Name of Supervisor

3. Salary/Wages Start

3. State Job Title and Responsibilities

3. Reason for Separation

3. May We Contact?

Yes

No

3. If No, Please Indicate Reason

REFERENCES

List below the names of three employment contacts, not related to you, who can provide information about your prior experience

1. Full Name

1. Address of Reference

1. Phone #

1. Years Known

1. Business/Company

2. Business/Company

2. Full Name

2. Address of Reference

2. Phone #

2. Years Known

3. Full Name

3. Address of Reference

3. Phone #

3. Years Known

3. Business/Company

By submitting this form, you acknowledge that you have read the job description and its terms and conditions and opt yourself to receiving emails/SMS from the company.