Application For Employment
AN EQUAL OPPORTUNITY EMPLOYER
Please answer all appropriate questions completely. All qualified applicants will receive consideration without discrimination based on sex, marital status, race, age, creed, national origin or the presence of disabilities (unless the disability limits your ability to perform the essential functions of the job). Additional job related testing for skills may be required. Testing for the presence of illegal drugs may be required prior to employment. Certain positions may require additional testing and medical reviews to determine job fitness. A medical review will be required (if necessary) only after a job offer has been made.
*THIS INFORMATION MAY BE ASKED FOR, BUT YOUR ANSWER IS OPTIONAL. DISCRIMINATION IN ANY MANNER BASED UPON THIS INFORMATION IS PROHIBITED BY FEDERAL LAW.
Roofing & Insulation Supply Location |
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First Name |
Middle
Initial |
Last Name |
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Street Address |
County |
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City |
State |
Zip |
No. of years at this address |
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Email |
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Addresses for past 3 years |
Street Address |
City |
State |
Zip |
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Street Address |
City |
State |
Zip |
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Home Telephone |
Cell/Business Telephone |
Are you over 18 years of age? |
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yes
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Have you ever applied for employment with us before? |
yes no |
Have you ever worked with this company or a related company? |
yes no |
If yes, when? |
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Position Held: |
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Position Desired: |
What date can you start? |
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Are you available for full-time work?
yes no |
If not, what hours can you work? |
Are you currently authorized to accept employment with any employer in the U.S.?
Will you now or in the future require sponsorship for employment visa status (e.g,. H-1B visa status)? no yes |
How did you find out about this position? |
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Driver's License # |
State Issued |
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Other special training or skills (languages, machine operation, etc.) |
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Emergency Contact |
Phone |
Relationship |
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EDUCATION |
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Have you served in
the Armed Forces? |
When? |
Which branch? |
Status of Discharge |
yes no |
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What equipment can you operate?
(Forklifts, Backhoes, Welders, Computers, Typewriters, Calculators, etc.) |
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EMPLOYMENT HISTORY
(Begin with the most recent) |
Company Name |
Telephone |
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Address |
Employed (Month and Year) |
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From
To
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Name of Supervisor |
Weekly Pay |
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Start
Last
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State Job Title and Describe Your Work |
Reason for Leaving |
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Company Name |
Telephone |
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Address |
Employed (Month and Year) |
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From
To
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Name of Supervisor |
Weekly Pay |
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Start
Last
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State Job Title and Describe Your Work |
Reason for Leaving |
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Company Name |
Telephone |
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Address |
Employed (Month and Year) |
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From
To
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Name of Supervisor |
Weekly Pay |
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Start
Last
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State Job Title and Describe Your Work |
Reason for Leaving |
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I, hereby declare all of the foregoing statements to be complete and true. I understand that as part of normal employment procedures an inquiry may be made concerning information on my character, general reputation, and personal characteristics. I authorize such an investigation and understand that upon my request, information as to the nature and scope of the inquiry, if one is made, will be provided. My present employer may
or may not
be contacted (check response). Any false or misleading statements or material omission in connection with this application may result in termination of any employment by Roofing & Insulation Supply of this applicant. All positions with Roofing & Insulation Supply are terminable "at will" by Roofing & Insulation Supply at any time. |
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