Apply - Cubellis Plumbing

Application for Employment

Cubellis Plumbing LLC

Application for Employment

APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS

Please check all that apply

Contractor License

Master License

Journeyman Plumber

No License

Date

Name

First Middle Last Maiden

Present Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

How Long:

Telephone:

Position Applied For:

Salary Desired:

Days/Hours Available to Work:

No Pref

Thur

Mon

Fri

Tue

Sat

Wed

Sun

How many hours can you work weekly?

Can you work nights? On-Call?

Employment Desired:

FULL-TIME ONLY

PART-TIME ONLY

FULL- OR PART-TIME

When available for work?

EDUCATION & OTHER INFORMATION

High School

TYPE OF SCHOOL

NAME OF SCHOOL

LOCATION (Complete mailing address)

NO. OF YEARS COMPLETED

MAJOR & DEGREE

College

TYPE OF SCHOOL

NAME OF SCHOOL

LOCATION (Complete mailing address)

NO. OF YEARS COMPLETED

MAJOR & DEGREE

Bus. or Trade School

TYPE OF SCHOOL

NAME OF SCHOOL

LOCATION (Complete mailing address)

NO. OF YEARS COMPLETED

MAJOR & DEGREE

Professional School

TYPE OF SCHOOL

NAME OF SCHOOL

LOCATION (Complete mailing address)

NO. OF YEARS COMPLETED

MAJOR & DEGREE

PLEASE IDENTIFY BELOW IF YOU HAVE EXPERIENCE WITH SERVICING THESE ITEMS:

Fixture

Have you ever been convicted of a crime?

Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Do you have a driver’s license?

Yes

What is your means of transportation to work?

Driver’s License Number:

State of issue:

Operator

Commercial (CDL)

Chauffeur

Expiration Date:

Have you had any accidents during the past three years?

How many?

Have you had any moving violations during the past three years?

How Many?

Please list two references other than relatives or previous employers.

Name:

Position:

Company:

Address:

Telephone:

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.

Job One

Name of Employer:

Name of Last Supervisor

Employment Dates

From

Employment Dates

From

Salary

Start

Salary

Final:

Complete Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number:

Your Last Job Title:

Reason for Leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Job Two

Name of Employer:

Name of Last Supervisor

Employment Dates

From

Employment Dates

To:

Salary

Start

Salary

Final:

Complete Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number:

Your Last Job Title:

Reason for Leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Job Three

Name of Employer:

Name of Last Supervisor

Employment Dates

From

Employment Dates

To:

Salary

Start

Salary

Final:

Complete Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number:

Your Last Job Title:

Reason for Leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer?

Yes

Did you complete this application yourself?

Yes

If not, who did?

PLEASE READ CAREFULLY

APPLICATION FORM WAIVER/CONFIDENTIALITY FORM

In exchange for the consideration of my job application by Cubellis Plumbing LLC (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Cubellis Plumbing LLC, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and Cubellis Plumbing LLC may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.

I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

Signature of Applicant

Date:

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in Cubellis Plumbing LLC.