Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

If You Are Under 18 Years Of Age, Can You Provide Required Proof Of Eligibility To Work? *

Yes

No

Have You Ever Applied With Us Before? *

Yes

No

Have You Ever Been Employed With Us Before? *

Yes

No

Do Any Of Your Friends Or Relatives (Other Than Spouse) Work Here? *

Yes

No

Are You Currently Employed? *

Yes

No

Are You Currently On "Lay-Off" Status & Subject To Recall? *

Yes

No

Are You Prevented From Lawfully Becoming Employed In This Country Because Of Visa Or Immigration Status? *

Yes

No

Can You Travel If A Job Requires It?

Yes

No

Are You Available To Work *

Full Time

Part Time

Temporary

What Is The Highest Level Of Education You Have Completed? *

High School Diploma/GED

Some College Credit, No Degree

Trade/Technical/Vocational Training

Associate degree

Bachelor’s degree

Master’s degree

Professional degree

Doctorate degree

Employer 1: May We Contact? *

Yes

No

Employer 2: May We Contact?

Yes

No

Employer 3: May We Contact?

Yes

No

Employer 4: May We Contact?

Yes

No

Have You Ever Been Convicted Of A Crime? *

Yes

No

Are There Any Felony Charges Pending Against You? *

Yes

No

Please Check Any Specialized Skills You Possess

Plumbing

HVAC

Refrigeration

Electrical

Framing/Drywall

Construction

Power Tool Experience

Automotive Repair

Mechanical Skills

Customer Service

APPLICANT'S STATEMENT *

I certify that answers given herein are true and complete. 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 45 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 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 an authorized executive 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 rules and regulations of the employer. By checking this box and typing my name, I certify that all information on this form is true and correct and authorize Whitcher Plumbing & Heating to perform a background check. I also agree that the checkbox and my name typed below are to be used as my electronic signature. I understand that I can be prosecuted if I provide false or misleading information.

I certify the above information is true and correct and I am the person submitting this application.