Hall Mechanical - Job Application

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difference a professional plumbing
service can provide your business.
800-817-5996

APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview should process should notify a representative of the organization.

Applicant name:

Date:

Social security no.:

Telephone:

Address:

Date available to start work:

If you are under 18, can you
furnish a work permit if it is
required?:

Yes

Have you ever been convicted
of a crime in the past 7
years?:

Yes

If yes, please explain (a
conviction will not
automatically bar
employment):

Education:
List school name and location, years completed, course of study, and any
degrees earned:

High school:

College:

Technical training:

Employment History:
(We need 7 years employment history - if necessary attach additional
information)

Employer:

Position held:

Address:

Telephone:

Immediate supervisor & title:

Salary:

Start date:

End date:

Reason for leaving:

Employer:

Position held:

Address:

Telephone:

Immediate supervisor & title:

Salary:

Start date:

End date:

Reason for leaving:

Employer:

Position held:

Address:

Telephone:

Immediate supervisor & title:

Salary:

Start date:

End date:

Reason for leaving:

Physical Record:
(We need specific details)

Do you have any physical
handicaps that preclude you
from performing any work for
which you are being
considered?:

Yes

If yes, please explain:

Were you ever injured?:

Yes

Give details:

Have you ever had a Workers
Compensation Claim?:

Yes

Give details:

Have you any hearing
impairments?:

Yes

In Vision?:

Yes

In Speech?:

Yes

Other Skills and Qualifications:
Summarize any job-related training, skills, licenses, certificates,
and/or other qualifications:

Other skills/qualifications:

References:
We require three (3) references. Names with current telephone numbers,
and years known (do not include relatives or employers)

Name:

Telephone:

Years known:

Name:

Telephone:

Years known:

Name:

Telephone:

Years known:

I hereby authorize the potential employer to contact, obtain, and verify the
accuracy of information contained in this application from all previous
employers, educational institutions, and references. I also hereby release from
liability the potential employer and its representatives for seeking, gathering and
using such information to make employment decisions and all other persons or
organizations for providing such information.

I understand that any misrepresentation or material omission made by me on
this application will be sufficient cause for cancellation of this application or
immediate termination of employment if I am employed, whenever it may be
discovered.

If I am employed, I acknowledge that there is no specified length of employment
and that this application does not constitute an agreement or contract for
employment. Accordingly, either I or the employer can terminate the relationship
at will, with or without cause, at any time, so long as there is no violation of
applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or
otherwise discriminate against a qualified individual with a disability because
ons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory
proof of identity and legal work authorization within three days of being hired.
Failure to submit such proof within the required time shall result in immediate
termination of employment.

I represent and warrant that I have read and fully understand the foregoing
and that I seek employment under these conditions.

Applicant signature:
Typing in your name
will serve as your signature.

Signature date:

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