Apex Plumbing Inc.

Employment Application

Please print, fill out, and mail or fax form to:

Apex Plumbing Inc.
16395 W. 54th Ave.
Golden, CO 80403
Fax Number: 303-278-8518
Office Number: 303-215-1348

Personal Information:

Name

 ___________________
___________________
___________________

Address

 ____________________
____________________
____________________

Phone Number

 ___________________
___________________

City

 ____________________

State

 ___________________

Date of Birth

 ___________________

Zip Code

 ___________________

Employment Desired:

Position Desired
___________________
___________________

Date you can start

___________________

Salary Desired

 ___________________

Are you currently employed?
Yes No


 

Former Employers:

(List below last four employers, starting with last one first)

Date (Month/Year) Name and Address of Employer Position Reason for Leaving
From ________
To __________

 

 ____________________
____________________
____________________
____________________ 		__________
__________
__________		 ______________
______________
______________
______________
______________
Date (Month/Year) Name and Address of Employer Position Reason for Leaving
From ________
To __________

 

 ____________________
____________________
____________________
____________________ 		__________
__________
__________		 ______________
______________
______________
______________
______________
Date (Month/Year) Name and Address of Employer Position Reason for Leaving
From ________
To __________

 

 ____________________
____________________
____________________
____________________ 		__________
__________
__________		 ______________
______________
______________
______________
______________
Date (Month/Year) Name and Address of Employer Position Reason for Leaving
From ________
To __________

 

 ____________________
____________________
____________________
____________________ 		__________
__________
__________		 ______________
______________
______________
______________
______________




 

 

Education History:

Name and Location of School

Years Attended

Did You Graduate?

Subjects Studied

High School

 ____________
____________ 		_______ Yes
No

 

N/A

College

 ____________
____________ 		_______ Yes
No

 

______________
______________

Trade, Business, or Correspondence School

 ____________
____________
____________
____________
 _______ Yes
No

 

_______________
_______________
_______________
_______________
_______________
_______________
Do you have a valid driver's license?
Yes No
Can you provide a current copy of your motor vehicle record?
 Yes No
Is there any other information regarding your qualifications, experience, etc. that you would like to include?
 _________________________
_________________________
_________________________
_________________________

Authorization

By signing this application, I hereby authorize the investigation of my past and present work, character, education, military and employment qualifications.

The release in any manner of all information is hereby authorized whether such information is of record or not, and I do hereby release all persons, agencies, firms, companies, etc., from any damages resulting from providing such information.

 

Signature
_________________________________________________

Date ____________________