Employment Opportunities and Application Immediate Openings: » Immediate opening for a licensed service plumber and for an experienced apprentice. Benefits and profit sharing. Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or handicap. Name Date Phone Address City State Zip Social Security # Date of Birth Are you a citizen of the United States of America? Yes No Height Weight You will be subject to a drug screening. If on any prescription medications please list: Employment Experience Start with your present job or last job. Include military assignments and other volunteer activities. Exclude organizational names which indicate race, color, religion, sex, or national origin. Employer 1 Dates of Employment Employer Name Address City State Zip Phone # Supervisors’ Name Job Title Reason for leaving From To Salary or Hourly Rate Employer 2 Dates of Employment Employer Name Address City State Zip Phone # Supervisors’ Name Job Title Reason for leaving From To Salary or Hourly Rate Employer 3 Dates of Employment Employer Name Address City State Zip Phone # Supervisors’ Name Job Title Reason for leaving From To Salary or Hourly Rate Education School 1 School or Collage Attended # Years at school Graduation Year Degree School 2 School or Collage Attended # Years at school Graduation Year Degree School 3 School or Collage Attended # Years at school Graduation Year Degree School 4 School or Collage Attended # Years at school Graduation Year Degree Describe any special qualifications for this job: Drivers License # State Expiration Are you a veteran of the U.S. Military service? Yes No I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigations of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given on my application or interview may result in termination. Type your name as your signature Date
