Personal Information

Field Technician Application

When applying for a position with our company, please understand that client trust is a foundation of our culture. From all applicants we require a 10 year background screening, driving record, and pre-screen drug test. We ask that all information provided on this application be accurate and forthright. We thank you for your interest in working at Bruce Roberts Company!

Personal Information
Name*

First Name, M.I. Last Name
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Level of Education

Grade SchoolHigh School DiplomaUndergraduate DegreeGraduate DegreeOther
Driver's License Number
Issuing State
Describe any job-related skills, special qualifications, professional licenses, or professional training

Employment History

Starting with your most recent or present job, list your past employers.
1

Most recent or current employer
Employer's Name
Phone Number
Please enter a valid phone number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed from mm/yyyy tomm/yyyy
Name of Current or Most Recent Supervisor
Last Job Title
Pay started at rate of pay and ended at rate of pay
Describe your Job Duties
Reason for Leaving
2
Employer's Name
Phone Number
Please enter a valid phone number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed from mm/yyyy to mm/yyyy
Name of Supervisor
Job Title
Rate of Pay
Describe your Job Duties
Reason for Leaving
3
Employer's Name
Phone Number
Please enter a valid phone number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employed from mm/yyyy to mm/yyyy
Name of Supervisor
Last Job Title
Rate of Pay
Describe your Job Duties
Reason for Leaving

Written Word

This give us a chance to get to know you a little better
Which trades are you most interested in pursuing a mastery of? What interests you about those particular fields? (ie. carpentry, masonry, electrical, plumbing, HVAC, etc.)
Find a photo of an interesting design feature in a home.

Upload image here
Cancelof
Describe why that design appeals to you.
Have you ever worked in the home maintenance and remodeling field? If yes, describe that experience. If not, why are you interested in exploring this field?

Professional References

Please provide 3 professional references for us to contact.
1
Full Name
Phone Number
Email
example@example.com
Company
Job Title
How do you know this individual?
2
Full Name
Phone Number
Email
example@example.com
Company
Job Title
How do you know this individual?
3
Full Name
Phone Number
Email
example@example.com
Company
Job Title
How do you know this individual?

Background Investigation Authorization
Full Name

First Name, Middle Initial Last Name
Other names utilized in you past professional career
Date of Birth

MonthDayYear
Social Security Number
May we contact your current employer?

YesNo
I understand that an offer of employment by Bruce Roberts Company may be made in reliance upon the statements contained herein, and may be contingent upon satisfactory results of an investigation of my past employment, experience, education, and other activities referred to in this application.

I voluntarily authorize Bruce Roberts Company to conduct such an investigation. I agree to cooperate fully in this investigation and to release from liability or responsibility, all persons or organizations supplying information.

Should I accept employment prior to the completion of any of the above, I understand that such employment, if subsequently terminated as a result of a finding other than satisfactory to Bruce Roberts Company, shall be deemed to have been temporary. I, therefore, shall not have been eligible for any of the employee benefits offered by Bruce Roberts Company.
Signature*

Clear
Date*

MonthDayYear

I, your name* certify that all information I have provided in this employment application is accurate and has been completed to the best of my knowledge and ability.
Signature*

Clear
Date*

MonthDayYear
Should be Empty:

Field Technician Application