Riley Hays Roofing & Construction
Employment Application
Name
First & Middle Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date Available
-
Month
-
Day
Year
Date
Social Security #
Position Applying for:
Are you a citizen of the United State?
*
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
Yes
No
If yes, when?
Have you ever been convicted of a felony?
Yes
No
If yes, explain?
Driver License:
Yes
No
References
Please list three professional references.
Name
First Name
Last Name
Relationship
Company
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Relationship
Company
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Relationship
Company
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Previous Employment
Company
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor
Job Title:
Starting Salary $:
Ending Salary $:
Responsibilities:
Start Date:
-
Month
-
Day
Year
Date
End Date:
-
Month
-
Day
Year
Date
Reason for Leaving:
May we contact your previous supervisor for a reference?
Yes
No
Disclaimer & Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Clear
Submit
Should be Empty: