NWI Employment Application 2021

Employment Application

National Water Infrastructure is an equal opportunity employer. National Water Infrastructure does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, protected veteran status or any other characteristic protected by law.
Personal Information
Name *

First Name Middle Name Last Name Suffix
Email Address

Email Address

Street Address Line 2
Address

Mailing Address

Address Line 2

City State

Zip Code
Phone Number

Area Code Phone Number
Are you legally eligible for employment in the United States?

Yes No
Are you at least 18 years of age or older? (If no, you may be required to provide authorization to work.)

Yes No
Are you at least 21 years of age or older? (If no, you may not be eligible for a driver position.)

Yes No
Employment Desired
Position applying for:
Hourly Rate/Annual Salary Desired:
If hired, what date can you start work?

Month Day Year
Date
How did you hear about the position?

Advertisement Walk In Employee or Relative
Are you applying for regular full-time work?

Yes No
Are you applying for regular part-time work?

Yes No
Are you applying for temporary work, e.g. summer or holiday work?

Yes No
Are there any days/hours on which you are unavailable to work?

Yes No
If yes, which days and hours are you unavailable for work?
If necessary, can you work overtime, including weekends?

Yes No
Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?

Yes No
Have you applied for employment with this Company before?

Yes No
If yes, date

Month Day Year
Date
Have you ever worked for National Water Infrastructure, Ascension Wastewater Treatment or Wastewater Treatment of Louisiana before?

Yes No
If yes, when and what position?
If yes, what was your reason for leaving?
Do you have any relatives currently working with the Company?

Yes No
If yes, please list their name

First Name Last Name
Do you know anyone who works for our Company?

Yes No
If yes, please list their name

First Name Last Name
If yes, please list their name

First Name Last Name
Employment History
Please list the names of your present and/or previous employers in chronological order with the present or most recent employer listed first.
Employer 1
Current or most Recent Employer
Job Title
Phone Number

Area Code Phone Number
Type of Business
Supervisor

Title First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Description of job and duties
Reason for leaving:
Is this your current employer?

Yes No
May we contact this employer for a reference?

Yes No
Employer 2
Name of Employer
Job Title
Phone Number

Area Code Phone Number
Type of Business
Supervisor

Title First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Description of job and duties
Reason for leaving:
May we contact this employer for a reference?

Yes No
Employer 3
Name of Employer
Job Title
Phone Number

Area Code Phone Number
Type of Business
Supervisor

Title First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Start Date

Month Day Year
Date
End Date

Month Day Year
Date
Description of job and duties
Reason for leaving:
May we contact this employer for a reference?

Yes No
Education, Training and Experience
High School Name
High School Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
High School: Number of years completed
Did you graduate high school?

Yes No
If not, do you have your General Education Development (GED)?

Yes No
College/University Name
College/University Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
College/University: Number of years completed
Did you graduate college or university?

Yes No
College/University Degree
Vocational, Trade, Graduate, etc. School Name
Vocational, Trade, Graduate, etc. School Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Vocational, Trade, Graduate, etc. School: Number of years completed
Did you graduate Vocational, Trade, Graduate, etc. school?

Yes No
Vocational, Trade, Graduate, etc. School Degree
Please provide any additional information that you believe would assist us in better evaluating your application:
If you have any professional certifications or job-related training, please provide details:
Professional References

Please list three people, who are not related to you, whom you have known at least (1) year and whom we may contact as a reference, if needed.
REFERENCE 1
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email Address

Street Address Line 2
Company/Position
Years Known
REFERENCE 2
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email Address

Street Address Line 2
Company/Position
Years Known
REFERENCE 3
Name

First Name Last Name
Phone Number

Area Code Phone Number
Email Address

Street Address Line 2
Company/Position
Years Known
Applicant Statement

Please read carefully before signing.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for National Water Infrastructure Services to hire me. If I am hired, I understand that either National Water Infrastructure Services or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of National Water Infrastructure Services has the authority to make any assurance to the contrary. I attest with my signature below that I have given to National Water Infrastructure Services true and complete information on this application. No requested information has been concealed. I authorize National Water Infrastructure Services to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
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This signature certifies that this Employment Application was completed by me, and that all entries on it and information contained in it are true and complete to the best of my knowledge. *

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Date
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Employment Application

Personal Information

Employment Desired

Employment History

Education, Training and Experience

Professional References

Applicant Statement