Apply To Work At Allen’sAllen’s Tri-State Mechanical

APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicatnts be given equal opportunity and that selection decisions be based on job-related factors.

Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

Job Applied For*

Today's Date

Are you seeking:*

Full-time
Part-time
Temporary

When could you start work?*

Name*

First Name Middle Name Last Name

Email

example@example.com

Phone Number*

Address*

Street Address Address Line 2 City State ZIP Code

Are you 18 years of age or older?*

Yes
No

Social Security*

If hired, can you furnish proof you are eligible tow ork in the U.S.?*

Yes
No

Have you ever applied here before?*

Yes
No

If yes, when?

Were you ever employed here?*

Yes
No

If yes, when?

Have you ever been convicted of any law violation? Include plea of "guilty" or "no contest." Exclude minor traffic violations.*

Yes
No

If yes, give details

(A conviction will not necessarily disqualify an applicant for employment.)

If employed, do you expect to be engaged in any additional business or employment outside of our job?*

Yes
No

If yes, give details

For driving jobs ONLY: Do you have a valid driver's license?*

Yes
No

Driver's License Number

Class of LIcense

State Licensed In

Have you had your driver's license suspended or revoked in the last 3 years?*

Yes
No

If Yes, give details

List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability or other protected status.)*

LIST NAME AND ADDRESS OF SCHOOLS

High School or GED

Name

Address

# of Years Completed

Diploma / Degree / Certification

Subjects Studied

College or University

Name

Address

# of Years Completed

Diploma / Degree / Certification

Vocational or Technical

Name

Address

# of Years Completed

Diploma / Degree / Certification

Subjects Studied

What skills or additional training do you have that relate to the job for which you are applying?*

What machines or equipment can you operate that relate to the job for which you are applying?*

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references.

Note: A job offer may be contingent upon acceptable references rom current and former employers.

Name of Employer*

Job Title and Duties*

Address*

Street Address Address Line 2 City State ZIP Code

Dates of Employment

Starting Pay*

Final Pay*

Supervisor(s)*

Phone Number*

Reason For Leaving*

Add Another Job?*

Yes
No

Name of Employer

Job Title and Duties

Address

Street Address Address Line 2 City State ZIP Code

Dates of Employment

Starting Pay

Final Pay

Supervisor(s)

Phone Number

Reason For Leaving

Add Another Job?*

Yes
No

Name of Employer

Job Title and Duties

Address

Street Address Address Line 2 City State ZIP Code

Dates of Employment

Starting Pay

Final Pay

Supervisor(s)

Phone Number

Reason For Leaving

Add Another Job?*

Yes
No

Name of Employer

Job Title and Duties

Address

Street Address Address Line 2 City State ZIP Code

Dates of Employment

Starting Pay

Final Pay

Supervisor(s)

Phone Number

Reason For Leaving

Have you ever worked or attended school under any other names?*

Yes
No

If yes, give names

Are you presently employed?*

Yes
No

If yes, whom do you suggest we contact?

Have you ever been fired from a job or asked to resign?*

Yes
No

If yes, please explain

Give three references, not relatives or former employers.

1st Reference

Name

Address

Phone

2nd Reference

Name

Address

Phone

3rd Reference

Name

Address

Phone

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from futher consideration for employment and may result in my dismissal if discovered at a later date.

I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I understand I may be required to successfully pass a drug screening examination. I hereby consent to a pre- and/or post-employment drug screen as a condition of employment, if required.

I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.

DateTime*

Signature*

Printed Signature

Name

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