Employment Application

IDEAL PLUMBING HEATING AIR & ELECTRICAL
APPLICATION FOR EMPLOYMENT
(Equal Opportunity Employer)
Please complete this application form and we will be in contact with you shortly.

GENERAL
Name* Home Phone*
Address Other Phone
City Email*
State Zip
Date Available for Employment
If employed and under 18, can you furnish a work permit?

 Yes No Not Applicable

Have you ever been employed by this company?

 Yes No

Are you employed now?

 Yes No

May we contact your present employer?

 Yes No

If, yes, please give name

If hired, can you submit verification of your legal right to work in the United States?

 Yes No

If applying for a position where driving is required do you have a valid driver’s license in this state?

 Yes No

What position are you applying for?

Are you interested in Full or Part Time Employment?

 Full Time Part Time

Can you perform the essential functions of the job(s) which you are applying?

 Yes No

Have you been convicted of a felony?
(Please note that a “Yes” answer will not bar you from consideration for employment.)

 Yes No

If yes, please explain
EDUCATION
 
  High School College
School Name
School Address
Course of Study
Degree Awarded
 
  Trade School Certification Program
School Name
School Address
Course of Study
Degree Awarded
REFERENCES

List three (3) non-relatives who are familiar with your qualifications and actual work history and ability.

Name Occupation Years Known Telephone
EMPLOYMENT EXPERIENCE
Current Employer   Starting Date
(mo/yr)
Address   Ending Date
(mo/yr)
Phone   Starting Salary per
 Month Year
Supervisor's Name   Ending Salary per
 Month Year
Duties
 
What did you like most about your job?  
Reason(s) for leaving  
Previous Employer   Starting Date
(mo/yr)
Address   Ending Date
(mo/yr)
Phone   Starting Salary per
 Month Year
Supervisor's Name   Ending Salary per
 Month Year
Duties
 
What did you like most about your job?  
Reason(s) for leaving  
Previous Employer   Starting Date
(mo/yr)
Address   Ending Date
(mo/yr)
Phone   Starting Salary per
 Month Year
Supervisor's Name   Ending Salary per
 Month Year
Duties
 
What did you like most about your job?  
Reason(s) for leaving  
Previous Employer   Starting Date
(mo/yr)
Address   Ending Date
(mo/yr)
Phone   Starting Salary per
 Month Year
Supervisor's Name   Ending Salary per
 Month Year
Duties
 
What did you like most about your job?  
Reason(s) for leaving  

This company is an equal employment opportunity employer. All applicants will be considered without regard to age, race, national origin, religion, gender, physical or mental disability, or other protected classifications in accordance with applicable federal and state equal employment opportunity laws. This company will strive to reasonably accommodate any physical or mental limitations of employees or applicants in order to accomplish the essential functions of the job.

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SUBMITTING THIS APPLICATION. IF YOU HAVE ANY QUESTIONS REGARDING THIS STAEMENT, PLEASE ASK THEM BEFORE SUBMITTING.

I certify that all answers and statements I have made on this application (and resume or any other supplementary materials) are true and complete without omissions. By signing below, I authorize IDEAL PLUMBING, HEATING, AIR & ELECTRICAL to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations names in this application to give you complete information and records regarding my employment, education, character and qualifications.

I understand that IDEAL PLUMBING, HEATING, AIR & ELECTRICAL is an AT WILL EMPLOYER and if hired, my employment can be terminated by the Company at any time, with or without cause and with or without notice. Likewise, the Company will respect my right to terminate my employment at any time, with or without cause and without notice.

I also understand that no representative of IDEAL PLUMBING, HEATING, AIR & ELECTRICAL has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the President.

I understand that IDEAL PLUMBING, HEATING, AIR & ELECTRICAL is a Drug Free Workplace and if hired, I will be requested to submit to a drug test as a condition of employment.

I understand this application is not an offer of employment and that no promises or representations of employment have been made to me at this time.

I have read, understand, and agree with the above.

This application is valid for only ninety (90) days from the date I signed. If I want to be considered for job openings more than ninety (90) days from the date signed, I will submit a new application.

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