Employment Application

Please complete the employment application below. Fields marked with an "*" are required.

Personal Information
  • If you have lived at your current address less than 1 year please submit previous address.

  • Are you a U.S. citizen or an authorized alien to work in the United States?

  • Do you have a valid license?

  • Do you have valid insurance?

  • What position are you applying for?

  • If Roofer what experience?

Military Service & Criminal Background
  • Present membership in National Guard or Reserves

  • Have you been convicted of a felony or misdemeanor in past 5 years?

  • If yes please describe.

Education
  • Did you Graduate?

  • Did you Graduate?

  • Did you Graduate?

Equal Opportunity Employment Information
  • The information supplied below is strictly voluntary and will in no way affect the processing of your employment status with this company. This information will only be used for statistical purposes. Thank you for your cooperation.

  • Gender

  • Race

  • Are you an individual with physical or mental impairment which substantially limits one or more of your major life activities?

  • Are you a veteran?

  • Status

Work Experience
  • List of Duties

  • List of Duties

  • List of Duties

References
Signature
  • By submitting your digital signature you are stating that all information you are providing is true and correct. You are also aware that if your license or insurance status change at any time you must inform the office immediately.



* The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age, or by other means. The term "employment applications," refers to all written inquires about employment or applications for employment or promotion, including, but not limited to, resumes or other summaries of the applicant's background. It relates not only to written preemployment inquires, but to inquires by employees concerning terms, conditions, or privileges of employment as specified in section 4 of the act.

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