Position(s) applied for:*

Name:*

First Middle Name/Initial Last

Address*

Street Address City State ZIP Code

Home Phone:

Other Phone:

Email:*

How were you referred to this Company?

Are you over the age of 18?*

(If under 18, hire is subject to verification of minimum legal age.)

Yes
No

Are you currently employed?*

Yes
No

May we contact your present employer?*

Yes
No

Are you available to work?*

Full Time
Part Time
Shift
Temporary

When can you start work?*

Have you ever applied to / worked for this Company before?*

Yes
No

If, yes, when?

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?*

Yes
No

If no, please explain:

If hired, would you have transportation to/from work?

Yes
No

EMPLOYMENT EXPERIENCE

Please provide details for your current or most recent job.

Employer:

Dates Employed (From/To):

Address:

Telephone Number:

Job Title:

Supervisor:

Salary/Hourly Rate: Starting:

Final:

Reason(s) for leaving:

Duties/Responsibilities:

Describe Other Work Experience:

SPECIAL SKILLS AND/OR QUALIFICATIONS

Summarize special job-related skills and qualifications acquired from employment or other experiences.

High School Name:

Location:

Years Completed / Diploma / Degree:

Undergraduate College or University Name:

Location:

Years Completed / Diploma / Degree:

Graduate or Professional Name:

Location:

Years Completed / Diploma / Degree:

State any additional relevant course work and information that would be helpful in being considered for employment.

APPLICANT’S DECLARATION

I certify that the answers provided on this application are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 60 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the President of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by all written or unwritten rules and regulations of the employer including random drug and alcohol testing both during employment and prior to hiring.

I agree with the statements above:*

Yes
No

Comments

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

Employment Application

Sam’s Mechanical is Hiring!

EMPLOYMENT EXPERIENCE

SPECIAL SKILLS AND/OR QUALIFICATIONS

APPLICANT’S DECLARATION