Rick Ray & Sons, Inc - Job Application

JOB APPLICATION

1514 W Jefferson St, Springfield, Illinois 62702 • 217.525.0001
Rick Ray & Sons Plumbing Inc 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.

Please fill out all of the sections below:
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date of Application*

MonthDayYear
Date
Employment Position
Position(s) applying for:*
How did you hear about this position?*
What days are you available for work?*
What hours or shift are you available for work?*
If needed, are you available to work overtime?*
On what date can you start working if you are hired?*

MonthDayYear
Date
Do you have reliable transportation to and from work?*
Salary desired:*
Personal Information
Have you ever applied to or worked for Rick Ray & Sons Plumbing Inc before?*

YesNo
If yes, when?
Do you have any friends, relatives, or acquaintances working for Rick Ray & Sons Plumbing Inc*

YesNo
If yes, state name & relationship:
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 status?*
Will you consent to a mandatory controlled substance test?*

YesNo
Do you have any condition which would require job accommodations?*

YesNo
If yes, please describe accommodations required below.
Job Skills/Qualifications
Are you a licensed plumber/apprentice?*

YesNo
If yes, please provide your license #:
Please list below the skills and qualifications you possess for the position for which you are applying*
Education and Training
High School
Name of High School*
Location*
City, State
Year Graduated*
Degree Earned*
College/University
Name of College/University
Location
City, State
Year Graduated
Degree Earned
Vocational School/Specialized Training
Name of Vocational School/Specialized Training
Location
City, State
Year Graduated
Degree Earned
Military:
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?
Previous Employment

List Most Recent First
Employer Name
Job Title
Supervisor Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Telephone
Format: (000) 000-0000.
Dates Employed
Reason for Leaving
Employer Name
Job Title
Supervisor Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Telephone
Format: (000) 000-0000.
Dates Employed
Reason for Leaving
Employer Name
Job Title
Supervisor Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Telephone
Format: (000) 000-0000.
Dates Employed
Reason for Leaving
References

Please provide 2 personal and professional reference(s) below:
Name & Relationship*
Reference 1
Contact Information*
Reference 1
Name & Relationship*
Reference 2
Contact Information*
Reference 2
AT-WILL EMPLOYMENT

The relationship between you and the Rick Ray & Sons Plumbing Inc is 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 Rick Ray & Sons Plumbing Inc . No representative of Rick Ray & Sons Plumbing Inc 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 Executive Vice-President/Chief Operations Officer or the Company's President.
Applicant Signature*
By signing, I hereby acknowledge that my electronic signature on this document shall be considered legally binding and have the same force and effect as a handwritten signature.
Dated*

MonthDayYear
Date
Should be Empty:

JOB APPLICATION

Applicant Information

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

High School

College/University

Vocational School/Specialized Training

Military:

Previous Employment

References

AT-WILL EMPLOYMENT