Maroon Plumbing Job Application Application PERSONAL INFORMATION: Full Name: * (Last) (First) (Middle) Social Security Number: * Date of Birth: * Drivers License #: * (State) (License #) Email: * Address * (Street Address) (City) (State) (Zip/Postal Code) Daytime Phone: * Evening Phone: * Mobile Phone: * RECRUITMENT INFORMATION: Position Desired: * Hourly Rate Requested: * Work Preference: * Full-time Part-time How did you learn about this company and position? * Job advertisementEmployee referralOther (Name of publication or other media): * (Name of employee): * (Agency, job fair, college recruitment office, etc.): * EDUCATION: For each level of schooling listed below, please give the school name, the city and state where it is located, your major and minor subjects, the year completed, and the degree or diploma received. High School High School Name City / State Degree or Diploma Received & Year College College Name Major Minor City / State Degree or Diploma Received & Year Business, Trade, Other Name of School Major Minor City / State Degree or Diploma Received & Year WORK HISTORY: Please list the following information regarding the last two companies for which you have worked: Current or Most Recent Are you currently employed? * Yes No Employers Name: * Employer's Address: * (Street Address) (City) (State) (Zip/Postal Code) Current Position: * Dates of Employment: * (Start Date) (End Date) Current salary (or hourly rate): * Job responsibilities: * Name of immediate supervisor(s): * Employer’s phone: * Employer’s fax: Prior Employment Employers Name: * Employer's Address: * (Street Address) (City) (State) (Zip/Postal Code) Position: * Dates of Employment: * (Start Date) (End Date) Your salary level (or hourly rate) when you left the company: * Job responsibilities: * Name of immediate supervisor(s): * Employer’s phone: * Employer’s fax: PERSONAL REFERENCES: Please provide three (3) personal references, only one (1) of which should be a co-worker or a relative. Personal Reference #1 Name * Relationship * Address: * (Street Address) (City) (State) (Zip/Postal Code) Phone * Fax Personal Reference #2 Name * Relationship * Address: * (Street Address) (City) (State) (Zip/Postal Code) Phone * Fax Personal Reference #3 Name * Relationship * Address: * (Street Address) (City) (State) (Zip/Postal Code) Phone * Fax Please answer the following questions regarding information pertaining to the applicant: Do you hold a valid plumbing license for the State of Texas? * Yes No If so, what license do you hold and please list your license number? * Have you ever been convicted of a felony or misdemeanor offense including any traffic violations? * Yes No If yes, please explain, including date of offense and the outcome. * Have you ever been terminated from employment? * Yes No If yes, please explain, including date and reason for dismissal: * What is your best trait or characteristic? * Describe an event where teamwork was required and how you successfully encouraged teamwork. * Describe a weakness that you have and how you have worked to overcome the weakness. * Do you have a valid driver’s license? * Yes No APPLICANT CONSENT: Please read each of the following statements and check the box by each one to indicate that you understand and agree to the terms stated, and then sign this form in the space indicated below. * I certify that all information I have supplied on this form is correct to the best of my knowledge. I understand that omissions or deliberate misinformation will disqualify my application or, if hired, would serve as grounds for dismissal. * I consent to have Maroon Plumbing contact the people listed on this form for references and authorize these individuals to provide truthful information regarding my qualifications for employment and previous work. I also agree to waive liability against persons named as references, provided the information they supply is honest, factual, and given without malice. * I give authorization to run a background check on my provided information. Today's Date * If you have a resume prepared, upload it here: Drop a file here or click to upload Choose File Maximum file size: 52.43MB If you are human, leave this field blank. Submit
