Employee Application Form (CHR)

Employment Application

Certified Home Repair, LLC
Company Information:
Employer: Certified Home Repair, LLC

Address: 65 Airport Dr, Suite A

City/State/ZIP: Blairsville, Georgia 30512

Office Email: Careers@chrllc.info

Telephone: (706) 897-1145

It is the policy of Certified Home Repair, LLC to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability, or veteran status.
Personal Information:
Full Name*

First NameMiddle NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How many years at this address?*
Phone Number*
E-mail*
example@example.com
Birth Date*

MonthDayYear
Social Security Number *
This is for background checking for pre-employment purposes.
Driver's License Number & State*
This is for background checking for pre-employment purposes.
Are You a U.S. Citizen?*

YesNo
Are You authorized to work in the USA?*

YesNo
Can you lift up to 50lbs (unassisted)?*

YesNo
Are you an active member or veteran of the United States Armed Forces?*

YesNo
Employment Desired:
Position Applying For*
Date You Can Start*

MonthDayYear
Salary Desired ($)*
Criminal History:

Note: You should not answer "Yes" to the following question if the conviction was solely for a minor traffic violation (e.g., speeding or parking tickets), or if the conviction was expunged, sealed, annulled, pardoned, or otherwise legally erased. THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE ANAUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.
Have You ever been convicted of a crime?*

YesNo
Please explain the nature of the convictions. I.e. a felony charge, violent crime, etc.
If you are unsure of how to answer, simply list the charge(s) you have been convicted of.
Drug Testing:

CHR is an active participant in the "Drug Free Workplace" Program, so pre-employment drug testing is required during employee onboarding.
Can you pass a drug test?*

YesNo
Education:
High School*
Name of High School Attended
Number of Years Attended*
Graduated?*

YesNo
College
Name of College/University Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNoCurrently Enrolled
Will you have educational obligations that require scheduling flexibility?

YesNoMaybe
Higher Education
Graduate School
Name of Graduate School Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNoCurrently Enrolled
Education - Trade School/Other
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Area of Study/Degree
Graduated?

YesNo
Skills/Qualifications:

Please list any and all relevant skills for the Construction Laborer and/or Project Management positions and to what degree (how long).
Skills*
List any relevant skills
Qualifications
List any relevant certifications or qualifications
Current Employment:
Current Employer*
Name of Current Employer or NONE if not Employed
Supervisor Name*
Current Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position*
Current Salary ($)
Reason for Leaving?*
Start Date*

MonthDayYear
Date
May We Contact?*

YesNo
Supervisor Contact Number*
Please enter a valid phone number.
Previous Employment:

We MUST have at least one previous employment references that are not family or friends. We will not process an incomplete employment application.
Previous Employer*
Name of Previous Employer
Position*
Previous Salary ($)
Reason for Leaving?*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Previous Employer*
Name of Previous Employer
Position*
Previous Salary ($)
Reason for Leaving?*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
References:

We MUST have at least two references that are not family or friends. We will not process an incomplete employment application.
Reference 1*
Name of Reference
Relationship*
Years Acquainted*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference 2*
Name of Reference
Relationship*
Years Acquainted*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference 3
Name of Reference
Relationship
Years Acquainted
Email
example@example.com
Phone Number
Please enter a valid phone number.
Additional
Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer:
Resume (Optional, But Preferred):
Resume

Cancelof
Send Application:
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for the rejection of my application or, if employment commences, immediate termination.

I authorize Certified Home Repair, LLC to contact former employers and educational
organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION, AND I UNDERSTAND AND AGREE TO ITS TERMS.
Date

MonthDayYear
Date
Signature

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Employment Application

Company Information:

Personal Information:

Employment Desired:

Criminal History:

Drug Testing:

Education:

Higher Education

Education - Trade School/Other

Skills/Qualifications:

Current Employment:

Previous Employment:

References:

Additional

Resume (Optional, But Preferred):

Send Application: