Job Application Form
People Working Cooperatively is an equal opportunity employer: EEO-Minorities/Females/Diabled/Veterans. If you require reasonable accommodation for any part of the application or hiring process due to a disability, you may submit your request by sending an email to hr@pwchomerepairs.org
Name
*
First Name
Last Name
E-mail
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applied Position
*
Earliest Possible Start Date
-
Month
-
Day
Year
Date
Upload Resume
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Upload Cover Letter or Other Additional Documents
Please do not exceed 200 words.
Referred by
*
Employee Referral
Online Job Board
PWC Website
Social Media
If referred by an employee, please list name below.
Have you previously worked for PWC or applied for a position with our organization?
*
Yes
No
Are you legally authorized to work in the United States? Can you provide proof of eligibility to work in the US? (Proof of eligibility will be required before you can be employed) Can you fernish a work permit?
*
Yes
No
Are you willing to work:
*
Overtime
Full Time
Part Time
Weekends
Are you at least 18 years of age?
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Yes
No
Do you have a reliable means of transportation to and from work?
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Yes
No
Have you obtained your high school diploma and/ or GED?
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Yes
No
Please share College/Degree/Major/Grade point average, if applicable.
Please list any additional job-related skills, educational institutions, licenses, certifications, specialized training, apprenticeships or further information you feel may be helpful to us in considering your application.
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Employment History
Employment History 1
*
Position/ Job Title
*
Company Name
*
Company Address
From (Month/Year) through (Month/Year)
*
Supervisor Name
*
May we contact?
*
Yes
No
Job Responsibilities:
*
Reason for leaving:
*
Employment History 2
Position/ Job Title
Company Name
Company Address
From (Month/Year) through (Month/Year)
Supervisor Name
May we contact?
Yes
No
Job Responsibilities:
Reason for leaving:
Employment History 3
Position/ Job title
Company Name
Company Address
From (Month/Year) through (Month/year)
Supervisor Name
May we contact?
Yes
No
Job Responsibilities:
Reason for leaving:
Employment History 4
Position/ Job Title
Company Name
Company Address
From (Month/Year) through (Month/Year)
Supervisor Name
May we contact?
Yes
No
Job Responsibilities:
Reason for leaving:
Reference 1 Name
*
Reference 1 contact information (Phone/Email)
*
Reference 1 Job Title/Company
*
Reference 2 Name
*
Reference 2 contact information (Phone/Email)
*
Reference 2 Job Title/Company
*
Reference 3 Name
*
Reference 3 contact information (Phone/Email)
*
Reference 3 Job Title/Company
*
Are you currently on lay-off and subject to recall?
*
Yes
No
Are you bound by any non-compete agreements with your current or former employer(s)? If yes, we will request a copy of the agreement
*
Yes
No
Do you have any commitments or other agreements with another employer that might affect your employment with PWC?
*
Have you ever been bonded? If so, has bond ever been refused or cancelled?
*
Have you ever been convicted of a felony or misdemeanor? If so, please explain below giving date, charge, county, and all other detailed matters pending and current status: (Conviction will not necessarily disqualify an applicant from employment)
*
If applying for a position that requires driving, do you have a valid driver's license?
Yes
No
Driver's license #:
Driver's license state:
Driver's license class:
Is your license CDL?
Yes
No
Do you have auto insurance?
Yes
No
Please describe any experience or special training received in the military or in government service related to the position you are applying.
If applying for a clerical position, what business equipment can you operate? (For example - computers, copiers, etc.)
List the specific skills, qualifications you possess related to the position for which you are applying.
In what computer software program(s) are you proficient?
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Job Applicant's Agreement & Certification
Please read the following statements carefully before signing.
Please type your full name as signature confirmation.
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
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Equal Employment Opportunity Information
People Working Cooperatively is an equal opportunity employer that is committed to a program of recruitment of females, minority group members, individuals with disabilities, and qualifying veterans. In order to comply with governmental reporting requirements, we request that you supply the information below. This information is voluntary and will in no way effect the processing of your application or your consideration for employment. This form should be submitted with the employment application, but will be processed separately and used for statistical purposes only. Please fill in the information requested and check all items that apply to you. Thank you for your cooperation.
Applicant's Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Gender:
Male
Female
Position Applied for:
Select which applies to you:
Hispanic or Latino
White (Not Hispanic or Latino)
Black or African American (Not Hispanic or Latino)
Native Hawaiian or other Pacific Islander (Not Hispanic or Latino)
Asian (Not Hispanic or Latino)
Native Indian or Alaskan Native (Not Hispanic or Latino)
Two or More Races (Not Hispanic or Latino)
PROTECTED VETERAN STATUS
I identify as one or more of the classifications of Protected Veterans listed above
I am not a protected veteran
We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure.
Yes, I have a disability, or have had one in the past
No, I do not have a disability and have not had one in the past
I do not wish to answer
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SUBMIT APPLICATION
Should be Empty: