Employment Application

EMPLOYMENT APPLICATION

Personal Information

First Name *

Last Name *

Address *

Phone Number *

Email Address

EMPLOYMENT Information

Citizen/Work Status *

Employment Desired

Full-Time

Part-Time

Current Employer (if any)

When are you available to start work? *

Do you have any criminal History? (if yes, describe below)

Do you have reliable transportation to work?

Yes

Driver License Number *

Do you have a clean driving record?

Yes

State of Issue *

List any moving violations and/or accidents from the last 3 years

How many years of experience do you have? *

Please list your plumbing work/skill experience *

List any certifications or licenses you have below

Please list work references below (Name and phone number) *

Is there any additional information you would like us to know?

AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)

I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.

I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with HEFMARK Plumbing & Filtration creates an actual or implied contract of employment.

I understand that, if I accept employment with HEFMARK Plumbing & Filtration, it will be on an at-will basis. This means that either HEFMARK Plumbing & Filtration or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.

I agree to submit to drug and alcohol testing, if requested by HEFMARK Plumbing & Filtration. I release HEFMARK Plumbing & Filtration and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing.

I authorize HEFMARK Plumbing & Filtration to investigate information concerning my education, licensing, certifications, driving record, criminal history, employment experiences and all other aspects of my background relevant to my proposed employment. I release HEFMARK Plumbing & Filtration and its employees from all liability arising from such investigation.

Sign Below (Electronic Signature) *

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Date