Name *
Email *
Date Of Birth
Address
Phone Number *
Driver's License#
State
Class
Do you have a good driving record?
Yes
No
Do You have your own transportation?
Yes
No
Do you have a current plumbing license?
Yes
No
All employees are required to furnish their own tools. Laborers and Apprentices are not required at the time of employment.
Do you have a full set of tools?
Yes
No
After employment, can you submit verification of your legal right to work in the United States?
Yes
No
Job you are applying for?
Plumber
Apprentice
Estimator
Supervisor
Date you can start employment?
Wage requirement?
Are you capable of performing in a reasonable manner, the essential duties of the job for which you are applying with or without reasonable
accomodation?
Yes
No
Previous Employers
Employer 1
Phone
Dates employed
Employer 2
Phone
Dates employed
References (Professional)
Name
Phone Number
Name
Phone Number
I certify that the foregoing is true and correct and understand that any misrepresentations or an omission of fact called for is cause for summary dismissal. I
understand that an investigation will be undertaken in the representation contained in this application, and authorize prior employers to release any and all information pertaining to my
fitness and that any offer of employment will be conditioned upon my passing standard background and drug screening. I acknowledge that this application does not constitute a contract of
employment, and that if I am hired, the company for any reason may terminate the employment relationship at any time at all.
Digital Signature *
Date *
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Reference Check Claim - Waiver Form
A. Verification Of Accuracy Of Statements Made In Employment Application:
I hereby certify that the information provided in my employment application dated above (and any resume or other materials submitted by me in connection with my effort to obtain employment
with A & A Plumbing) is true, complete, and accurate; and I understand that any false or misleading information or significant omissions may disqualify me from any further consideration
for employment with A & A Plumbing, or could be justification for dismissal from employment, if discovered at any point after I have been hired or offered employment.
B. Release of Claims Against Providers of References and/or Other Employment Related Information:
With the exception of contacting my current employer (discussed below), I fully authorize the investigation and verification of any statements made by me in my employment application dated
above (and any resume or other materials submitted by me in connection with my effort to obtain employment with A & A Plumbing). I expressly authorize you to contact all listed past
employers and/or references. I further authorize any person, school, past employer, or other person, organization, or entity listed in my application, and any resume or other materials
submitted by to provide A & A Plumbing with any information requested that may be relevant and useful to A & A Plumbing in making a hiring decision. I expressly release any such
persons, organizations, or entities from any and all legal liability disclosure of any information about me, which it is permitted, by law, to release.
C. Contact With Current Employer:
I DO / DO NOT
authorize you to contact my current employer. If, and only if, I have authorized you to contact my current employer, I agree that the terms set forth in paragraph B also apply to my current
employer.
I DO
DO NOT
Initials (I have read and understand sections A, B, and C) *
Digital Signature *
Date *
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Image Verification