Employment Application

Employment Application

J.L. Roberts Mechanical Contracting
Full Name*

First NameMiddle NameLast Name
Email Address*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Social Security Number*
Driver's License Number*
Date of Birth*

MonthDayYear
Date
Referred by
Desired Position*
Other
Available Start date*

MonthDayYear
Desired Salary*
Are you a citizen of the United States?*

YesNo
If no, are you authorized to work in the United States?

YesNo
If yes, when?
Have you ever been convicted of a felony?*

YesNo
If yes, explain:
Do you have a physical condition that might limit your ability to perform the job for which you are applying?*

YesNo
If yes, please describe:

Employment Application

J.L. Roberts Mechanical Contracting
Education History

Please provide your education history.
Highest Level of Education*
Did you graduate?*

YesNo
Degree
I have attended Business or Trade School.

YesNo
If yes, provide name, location and degree/license achieved.
I have served in the military.

YesNo
If yes, provide the division rank.

Employment Application

J.L. Roberts Mechanical Contracting
References

Please list three professional references.
Name*

First NameLast Name
Company*
Relationship*
Phone Number*

Area CodePhone Number
Name*

First NameLast Name
Company*
Relationship*
Phone Number*

Area CodePhone Number
Name*

First NameLast Name
Company*
Relationship*
Phone Number*

Area CodePhone Number

Employment Application

J.L. Roberts Mechanical Contracting
Employment History

Please provide your employment history.
Employer Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Start Date: MM/YY*
Input starting month and year only (MM/YY format).
End Date: MM/YY*
Input ending month and year only (MM/YY format).
Position*
Salary*
Reason for Leaving*
Add Employer*

YesNo
Employer Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Start Date: MM/YY*
Input starting month and year only (MM/YY format).
End Date: MM/YY*
Input ending month and year only (MM/YY format).
Position*
Salary*
Reason for Leaving*
Add Employer*

YesNo
Employer Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Start Date: MM/YY*
Input starting month and year only (MM/YY format).
End Date: MM/YY*
Input ending month and year only (MM/YY format).
Position*
Salary*
Reason for Leaving*
Upload Resume

Upload a File
Optional Cancelof
From Name*

Employment Application

J.L. Roberts Mechanical Contracting
Disclaimer and Signature

Please read, accept and sign the following disclaimer.
The information provided in this Employment Application is true, correct and complete. If employed, any misstatement or omission of fact on this Employment Application may result in immediate termination of my employment.

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

I understand that it is J.L. Roberts Mechanical Contracting LLC's policy to prohibit the use, possession, transportation or sale of illegal and non-prescribed drugs and alcoholic beverages by its employees on the company's premise, by the company's employees while on duty or by the company's employees in such a way that could damage the company's reputation in the general public. I understand that use of illegal or non-prescribed drugs, or alcoholic beverages in any such fashion is a violation of J.L. Roberts' policy. Accordingly, I hereby agree to submit a pre-employment drug and/or alcohol test as a condition for my potential employment. I understand that failure to cooperate with any testing procedure will disqualify me from consideration for employment. I authorize any laboratory or medical provider to release test results to J.L. Roberts, and I expressly authorize J.L. Roberts to release any test related information, including positive results, as needed. I understand that this agreement in no way limits my right to terminate my employment or be terminated in accordance with federal and state law. My signature below constitutes my consent to provide a sample of my blood, breath, urine or other related sample for alcohol and drug testing analysis.
Acceptance*

I understand and accept the above disclaimer.
Signature*

Clear

Employment Application

J.L. Roberts Mechanical Contracting
Background Inquiry Release

Please read, accept and sign the following release.
In connection with my application for employment, I understand that an investigative background inquiry may be made on myself, including, but not limited to, identity and prior address(es) verification, criminal history, driving record, consumer credit history, education verification, prior employment verification, reference checks and other information as desired. I, further understand that for purposes of this background inquiry, various sources will be contacted to provide information, including but not limited to various federal, state, county, municipal, corporate, private and other agencies or entities, which may maintain records concerning my past activities related to my criminal conduct, civil court litigation, driving record and credit performance and other personal information. I hereby authorize without reservation any company, agency, party or other source contacted to furnish the above information as requested. I do hereby release, discharge and indemnify Advance Screening Solutions LLC, J.L. Roberts Mechanical, their agents, and associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses arising from the retrieving and reporting of the requested information. I acknowledge that a photocopy of this authorization may be accepted with the same authority as the original. This signed release expires one (1) year after the date of origination. Please use your full legal name below.
Acceptance*

I understand and accept the above background inquiry release.
Today's Date*

MonthDayYear
Date
Full Name*

First NameMiddle NameLast Name
Signature*

Clear
Should be Empty:

Employment Application

Employment Application

Education History

Employment Application

References

Employment Application

Employment History

Employment Application

Disclaimer and Signature

Employment Application

Background Inquiry Release