REH JOB APPLICATION

R. E. HARRINGTON PLUMBING, HEATING & UTILITIES

300 W 23RD STREET , BALTIMORE MARYLAND 21211
JOB APPLICATION
Please fill out all of the sections below:
Applicant Name
Address

Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Telephone Number
Email Address
example@example.com
Date of Application

MonthDayYear
Date
Employment Position
Employment Position: Position(s) applying for:

LaborerOperatorTruck DriverSupervisorOther
How did you hear about this position?
If needed, are you available to work overtime?

YESNO
On what date can you start working if you are hired?

MonthDayYear
Date
Do you have reliable transportation to and from work?

YESNOOther
Salary desired
Personal Information
Have you ever applied to or worked for R. E. Harrington PHU before? If yes, when?

YESNO
If yes, when?
Do you have any friends, relatives, or acquaintances working for R. E. Harrington PHU?

YESNO
If YES, please state name(s).
Are you 18 years of age or older?

YESNO
Are you a U.S. citizen or approved to work in the United States?

YESNO
What document can you provide as proof of citizenship or legal
Will you consent to a mandatory and random controlled substance test?

YESNO
Do you have any condition which would require job accommodations?

YESNO
If yes, please describe accommodations required below.
Have you ever been convicted of a criminal offense (felony or misdemeanor)?

YESNO
If yes, please state the nature of the crime(s), when and where convicted and disposition of the case
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect te description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered
Job Skills/Qualifications Please list below the skills and qualifications you possess for the position for which you are applying
(Note: R. E. Harrington PHU complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Itispossible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional
Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?
Education and Training

High School, College/University, Vocational/Specialized Training
School / College / University*
Previous Employment Employer Name:
Job Title:
Employer Name:
Supervisor'e Name:
Employer's Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's Phone Number:
Please enter a valid phone number.
Dates Worked:
Reason For Leaving:
Salary:
Job Title2:
Employer's Name2:
Supervisor's Name 2:
Employer's Address2:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer's Phone Number2:
Please enter a valid phone number.
Dates Worked2:
Reason for Leaving2:
Salary2:
Please provide 3 personal and professional reference(s) below:
Reference 1:
Contact Information 1:
Reference 2:
Contact Information 2:
Reference 3:
Contact Information 3:
Additional Information
Do you have any previous utility work experience? Yes or No If yes, please describe below.
If yes, please describe below.
Do you have any Maryland Driver's License? (DOT Mandated)

MonthDayYear
Date
Do you possess a OSHA SAFETY TRAINING Card? Yes or No Are you willing to get a OSHA SAFETY TRAINING CARD to drive company vehicles?
No
Are you willing to get a OSHA SAFETY TRAINING CARD to drive company vehicles?
Are you able to arrive to work on time and work until the job is finished?
Are you able to arrive to work on time and work until the job is finished? Yes or No
No
Are you a member of a Union Local? Yes or No If yes, which Union
No
If yes, which Union
Applicant Signature

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You must have a strong work ethic and be willing to work as a team player. REH is guided by Safety, Compliance and Production.

The relationship between you and the R. E. Harrington Plumbing, Heating & Utilitiesis referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the REH. No representative of R. E. Harrington Plumbing, Heating & Utilities has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our President or Operations Officer.
Dated

MonthDayYear
Date
R. E. Harrington Plumbing, Heating & Utilities is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.
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R. E. HARRINGTON PLUMBING, HEATING & UTILITIES

JOB APPLICATION

Personal Information

Education and Training

Additional Information