Personal
Info
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*First
Name:
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*Last
Name:
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*Home
Phone:
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Message Phone:
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*Email:
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*Street
Address:
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*City,
State, Zip:
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If
employed, can you provide proof of U.S.
citizenship?
Yes
No
N/A |
Are
you 18 or over?
Yes
No
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Position
applying for:
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Referred
by:
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If
employed, will you be able to travel and
work on projects throughout the State of
Washington?
Yes
No |
Do
you hold a current Washington Drivers license?
Yes
No
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What
is your Drivers license #?
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Have
you been convicted of a crime (other than
traffic violations) or been imprisoned during
the last seven years? A conviction will
not necessarily bar you from employment.
Yes
No
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If
yes, Please explain?
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Names
of friends or relatives that are employed
by Addicott Roofing:
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Do
you have any physical or mental disability
that may limit your performance in the job
you are applying for?
Yes
No
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If
yes, Please explain?
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*How did you
hear about Addicott Roofing?
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| Education
Record |
| High School:
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| Address: |
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| Dates Attended:
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| Degrees or diplomas:
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| College/University:
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| Address: |
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| Dates Attended:
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| Degrees or diplomas:
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| Trade or
technical training: |
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| Address: |
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| Dates Attended:
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| Degrees or diplomas:
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Employment
History
Begin with most recent
employer |
| 1. Employer:
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| Dates of employment:
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| Address: |
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| City, State,
Zip: |
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| Phone: |
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| Beginning salary:
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| Ending salary:
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| Title/Duties:
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| Supervisor's
name: |
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| Reason for leaving:
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| |
| 2. Employer:
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| Dates of employment:
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| Address: |
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| City, State,
Zip: |
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| Phone: |
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| Beginning salary:
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| Ending salary:
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| Title/Duties:
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| Supervisor's
name: |
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| Reason for leaving:
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References
List two professional
references who are familiar with the quality
of your work, have worked directly with
you, and have known you at least two years
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| 1. Reference:
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| Work phone:
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| Home phone:
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| Address: |
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| City, State,
Zip: |
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| Relationship:
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| 2. Reference:
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| Work phone:
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| Home phone:
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| Address: |
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| City, State,
Zip: |
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| Relationship:
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The information provided in this Application
for Employment is true, correct, and complete.
If employed, any misstatement or omission
of fact on this application may result in
my dismissal. I understand that acceptance
of an offer of employment does not create
a contractual obligation upon the employer
to continue to employ me in the future.
If you decide to engage an investigative
consumer reporting agency to report on my
credit and personal history I authorize
you to do so. If a report is obtained you
must provide, at my request, the name of
the agency so I may obtain from them the
nature and substance of the information
contained in the report. |
*
Typing your full name in the following
space constitutes your legal signature:
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*
Today's Date:
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| *
indicates required field. |
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