Online Application

Step 1 of 7

Position applying for:

EMPLOYEE INFORMATION

Name*

First Middle Last

Phone*

Email*

Alternate Phone

Address*

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

Are you over the age of 18*

Yes

I am legally eligible for employment in the U.S.:*

Yes

I am seeking a permanent position:*

Yes

EMPLOYMENT HISTORY

List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.

Employer name and address:

Pay:

Per:

Position title/duties, skills:

Supervisor:

Phone

Start date

End Date

Reason for leaving:

Employer name and address:

Pay:

Per:

Position title/duties, skills:

Supervisor:

Phone

Start date

End date

Reason for leaving:

Employer name and address:

Pay:

Per:

Position title/duties, skills:

Supervisor:

Phone

Start date

End date

Reason for leaving:

Employer name and address:

Pay:

Per:

Position title/duties, skills:

Supervisor:

Phone

Start date

End date

Reason for leaving:

Summarize other employment related to this job:

REFERENCES

List two former supervisor references

Name

First Last

Address

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

Phone

Occupation

Years known

Name

First Last

Address

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

Phone

Occupation

Years known

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its terms. I understand and agree to the information shown above.

Signature of Applicant

Date

Equal Employment Opportunity:

While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment.

Aderhold Roofing Pre-Employment Driver Screening Acknowledgement Form

It is the policy of Aderhold Roofing to hire only those drivers who are qualified and competent to operate our vehicles in a safe and lawful manner. Motor Vehicle Records will be obtained on all prospective drivers prior to hiring or assigning driving duties. An adverse driving record or lack of active driver’s license will eliminate an applicant from consideration of employment. I understand the above and agree to have my Motor Vehicle Records reviewed as a part of the pre-employment screening process.

POTENTIAL EMPLOYEE’S NAME

Date

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Employment Application

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EMPLOYEE INFORMATION

If necessary for the job, I am able to:

EMPLOYMENT HISTORY

MILITARY

SKILLS & QUALIFICATIONS

REFERENCES

INFORMATION TO THE APPLICANT

Equal Employment Opportunity:

Aderhold Roofing Pre-Employment Driver Screening Acknowledgement Form

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