Job Application Form

Full Name*

First NameMiddle NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Postal / Zip Code

Phone Number*

E-mail*

Position Desired*

Date You Can Start*

Date

Salary Desired*

Aside from wages and benefits, please list what matters to you most at work in order of importance:*

LIST YOUR TOP 3

How did you hear about Capitol Roofing?*

Have You Worked Here Before?*

YesNo

Have You Applied Here Before?*

YesNo

Are you at least 18 years old? *

YesNo

If hired, can you furnish proof that you are authorized to work in the U.S.? *

YesNo

Have you ever been convicted of any law violations, except minor traffic violations? (a criminal record does not automatically bar employment) *

YesNo

Have you ever been discharged from a job for cause? *

YesNo

Have you ever been discharged for absenteeism and/or tardiness by a previous employer? *

YesNo

Do you have prior roofing or construction experience?*

YesNo

If so, what kind of experience? *

List any licenses, certificates or professional affiliations you may have:*

If none, complete with N/A or None.

List any special skills you may have (computer, machine operation, etc.) *

If none, complete with N/A or None.

Are you willing to purchase personal hand tools needed for performing the work? (some available for payroll deduction)*

YesNo

FOR DRIVER APPLICANTS: Do you have a valid driver's license?

YesNo

Please list Class and in what State.

If none, complete with N/A or None.

FOR DRIVER APPLICANTS: Have you had your driver's license suspended or revoked in the last three years?

YesNo

Select type of work you are applying for:*

Part TimeFull TimeTemporary or Short Term

Will you work overtime on occasion, if necessary?*

YesNo

Will you work Saturday or Sunday, if necessary?*

YesNo

Will you work out of town for up to a couple of weeks at a time, if necessary?*

YesNo

Are you or do you expect to be engaged in any other business, employment or schooling?*

YesNo

Do you have any commitments or agreements with another employer that might affect your employment?*

YesNo

Do you have any on-going obligations or other personal commitments that would affect your work schedule?*

YesNo

Do you have reliable transportation to get you to job sites if needed (within 50 miles)? *

YesNo

If requested, would you be willing to take a drug/alcohol screening exam before and/or after employment as a condition of employment? *

YesNo

High School*

Name of High School Attended

Number of Years Attended*

Graduated?*

Yes

College

Name of College/University Attended

Number of Years Attended

Graduated?

Yes

Area of Study/Degree

Trade School/Other

Name of Trade/Technical/Other School Attended

Number of Years Attended

Graduated?

Yes

Area of Study/Degree

Current Employer*

Name of Current Employer or NONE if not Employed

Address*

Phone Number*

Position*

Job Responsibilities*

Salary*

Start Date*

Date

Reason for Leaving?*

Name of Supervisor*

May We Contact?*

YesNo

Previous Employer*

Name of Previous Employer

Position*

Job Responsibilities*

Supervisor*

Salary*

Reason for Leaving?*

Start Date*

Date

End Date*

Date

Previous Employer

Name of Previous Employer

Position

Job Responsibilities

Supervisor

Salary

Reason for Leaving?

Start Date

Date

End Date

Date

Cover Letter

Resume

By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employement may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I understand that no one other than the company president has authority to enter into any employment agreement to the contrary. I agree to take a job-related physical examination or a drug/alcohol test when requested as a condition of employment. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.

Signature*

Today's Date*

Date

Application For Employment

Personal Information:

Employment Desired:

Roofing Experience:

Availability for Work:

Education:

Current Employment:

Previous Employment:

Cover Letter & Resume (Optional):

Send Application: