Application for Employment (Maintenance)

APPLICATION FOR EMPLOYMENT

(FOR MAINTENANCE ONLY)
Personal Information
Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employment Desired
Are you eligible to work in the US?
Have you ever been employed here before?

If yes, when:
Position Applying For:
Desired Salary:
Date Available for Work:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Driver’s License:

Yes, state:
Do you have reliable transportation?
Seeking:
Are you at least 18 years old?
Education
Level of Education
Have you ever been convicted of a crime? Please Explain:
Experience

Please check all that you have experience in and how long you worked on each one. Also rate yourself on a scale from 1-5 on how proficient you are at each job. (5 being the best)

Rows	Yes/No	Number of Years	Notes
Carpentry
Plumbing
Heavy Equipment
Masonry
Dry Wall
Landscaping
Carpet
Tile
Appliances
Water Heaters
Painting
Concrete
Metal Doors
Windows
Siding
Baseboards/Trims
Cabinets
Electricity

Please list any special licenses or training you have in construction work.

Other training and experience; please indicate your experience of each item below.

Rows	Experience Level	Notes
Being responsible and completing maintenance requests
Assisting in the monitoring of work done by sub-contractors
Scheduling and completing preventative maintenance checks
Maintaining Inventory controls for cost effective operations
Assuring safety standards are used at all times
Being literate in the English language including reading
Basic working knowledge of data entry or word processing
Ability to take directives from several different people

Employment

Beginning with the most recent, list all past employers for at least the last five years.
Name & Address
Supervisors Name:
Reason for Leaving:
Beginning with the most recent, list all past employers for at least the last five years below.
References
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I hereby attest that the information provided by me is truthful and can be verified if need be. Any misrepresentations could be terms for dismissal if hired for a job.

I certify that the information given by me in this Application is true and correct. I understand and agree that if I provide any false or misleading information on this Application or in my pre-employment interviews, it may result in the revocation of an offer or employment or an immediate termination of my employment regardless of when it is discovered.

I understand that any offer of employment is contingent upon my providing proof of identity and eligibility to work in the United States.

I will complete a pre- employment drug test that is required by employer

I hereby expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume' or job interview. I hereby waive and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I hereby authorize SCRHA3 to investigate and obtain any and all oral and documentary information regarding my past employment, education, experience, and qualifications.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

APPLICATION FOR EMPLOYMENT

Personal Information

Employment Desired

Education

Experience

Employment

References