Employment

GENERAL

Name(Required)

Address(Required)

Email(Required)

Enter Email Confirm Email

Telephone(Required)

Social Security Number(Required)

Date available for employment

If employed and under 18, can you furnish a work permit?

Yes

No

Have you ever been employed by this company?

Yes

No

Are you currently employed?

Yes

No

May we contact your present employer?

Yes

No

Please provide current employer name & telephone number if we may contact.

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?

Yes

No

Type of work desired

Do you have a valid driver's license in this state?

Yes

No

Can you perform the essential functions of the job(s) for which you are applying?

Yes

No

Are you available for work:

Full-Time

Part-Time

Over-Time

Have you ever been convicted of a felony?

Yes

No

(Please note that a "YES" answer will not bar you from consideration for employment)

if Yes, please explain:

This company is an equal employment opportunity employer. All applicants will be considered without regard to age, color, national origin, disability, sex, or other protected status in accordance with applicable federal and state equal employment opportunity laws. This company will strive to accommodate any physical or mental limitations of employees or applicants in order to accomplish the essential function of a job.

EDUCATION

ELEMENTARY

School Name & Address

Years Completed

Course of Study

SECONDARY

School Name & Address

Years Completed

Course of Study

COLLEGE

School Name & Address

Years Completed

Course of Study

GRADUATE

School Name & Address

Years Completed

Course of Study

Special skills, qualifications and considerations:

Summarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking:

REFERENCES

List three non-relatives who are familiar with your qualifications and actual work history and ability.

Name(Required)

Occupation/Relationship(Required)

Years Known(Required)

Telephone(Required)

Name(Required)

Occupation/Relationship(Required)

Years Known(Required)

Telephone(Required)

Name(Required)

Occupation/Relationship(Required)

Years Known(Required)

Telephone(Required)

EMPLOYMENT EXPERIENCE

Add Previous Employment History

Employer	Date Employment Ended	Date Employment Started	Actions
There are no Entries.

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. FI YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK EMPLOYER BEFORE SIGNING.

I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. I understand that any false information will be grounds for refusal to hire or for immediate discharge if I am employed. I authorize any of the persons or organizations names in this application to give you complete information and records regarding my employment, education, character and qualifications.

Yes

No

If hired I will be responsible for familiarizing myself with all rules and regulations of Keith McNeill Plumbing Cont. Inc. as they presently exist or are later modified. If hired Irecognize that my employment can be terminated, at the discretion of Keith McNeill Plumbing Cont. Inc. or at my option, without notice, at any time, except as specifically set forth in writing in a current individual employment agreement.

Yes

No

I also understand that no representative of Keith McNeill Plumbing Cont. Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the President.

Yes

No

I understand this application is not an offer of employment and no promises or representatives of employment have been made to me at this time.

Yes

No

This application is valid for only ninety (90) days from the date Isigned. If I want to be considered forjob openings more than ninety(90) days from date signed, I will submit a new application.

Signature of Applicant

Name

This field is for validation purposes and should be left unchanged.

How To Apply

GENERAL

EDUCATION

REFERENCES

EMPLOYMENT EXPERIENCE

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. FI YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK EMPLOYER BEFORE SIGNING.

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