Job Application |

Job Application

Name

First Last

Phone

Email

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Can you provide your Social Security Number if needed?

Yes
No

Only U.S. citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment, submit documentation verifying your legal right to work and your identity?

Yes
No

Have you ever committed, been convicted of, plead guilty or not contest to, or had adjudication withheld with respect to a crime other than a minor traffic offense?

Yes
No

If yes, give dates and explain. List all such actions.

Are you over the age of 18?

Yes
No

Have you had any tickets within the last 5 years?

Yes
No

Are you a veteran of the U.S. Military Service?

Yes
No

If yes, what branch?

Beginning date of active duty

End date of active duty

Rank at time of discharge

Drivers License #

State of Issuance

Has your license ever been suspended or revoked?

Yes
No

If yes, explain

Do you have any DUI or DWI convictions?

Yes
No

If yes, explain

Do you have automobile insurance?

Yes
No

Do you have reliable transportation to get to and from the job site(s)?

Yes
No

Have you taken any illegal drugs in the past 30 days?

Yes
No

Are you now employed?

Yes
No

May we contact your current employer?

Yes
No

Are you on a layoff?

Yes
No

Are you subject to recall?

Yes
No

Will you work overtime if asked?

Yes
No

Are there any hours, shifts or days you will not work?

Yes
No

If yes, explain

Do you have any friends or relatives who work here?

Yes
No

If yes, please give name and relationship.

Have you applied here before?

Yes
No

If yes, when?

Have you ever been employed here before?

Yes
No

If yes, when?

How did you hear about this job opening?

What prompted you to apply?

Educational History

High School Information

High School Name

City / State

Years Completed

Describe specialized training, apprenticeship, skills and extracurricular activities

College Information

College or Other

Diplomas or Degrees

City / State

Years Completed

Course of Study

Honors Received

Have you ever had prior job or educational experience which relates to the job for which you are applying?

Yes
No

If Yes, Explain

Former Jobs

List most recent first. Account for all time periods including unemployment, self employment and military service.

1st Former Employer

Employer 1

Start Date

End Date

Work Performed

Address

Phone

Job Title

Hourly Rate or Salary for Starting and Final

Immediate Supervisor

May we contact this employer?

Yes
No

Reason for leaving:

2nd Former Employer

Employer 2

Start Date

End Date

Work Performed

Address

Phone

Job Title

Hourly Rate or Salary for Starting and Final

Immediate Supervisor

May we contact this employer?

Yes
No

Reason for leaving:

Please explain any gaps in employment history:

Have you ever been asked to or been forced to resign?

Yes
No

If Yes, Explain.

Did you receive any discipline in the last 12 months of active employment?

Yes
No

If Yes, Explain

Were you given a performance evaluation within the last 12 months of active employment?

Yes
No

If yes, what was the range of scores used and what was your score?

Have you ever signed any non-compete agreement with any other employer that would restrict you from working for this company?

Yes
No

If yes, explain.

Character References

List 3 persons not related to you, whom you have known for at least 1 year.

Name of Reference 1

Phone # of Reference 1

Address of Reference 1

Occupation of Reference 1

Name of Reference 2

Phone # of Reference 2

Address of Reference 2

Occupation of Reference 2

Name of Reference 3

Phone # of Reference 3

Address of Reference 3

Occupation of Reference 3

Position Information

Job Applying for:

Salary Requested

When can you start?

List any information/remarks you wish to have considered as a part of your application.

Verify your Information

Please Initial Here:

I certify that the answers given by me to the above questions and statements are true and correct and hereby authorize you to contact references, past or present employers, persons, schools, law enforcement agencies and any other sources of information which may be relevant to my application for employment. It is understood and agreed that any misrepresentation, false statement or omissions by me in the application will be sufficient reason for rejection of my application or for dismissal at any time during my employment, without liability to this company.

Please Initial Here:

I further understand that no representation of the company has the authority to enter into any agreement for employment for any special period of time and that this company is not guarantying employment for anyone. No employment contract is created by virtue of my being hired by the company. I agree, as condition of employment, to sign an arbitration agreement governing the terms and conditions of my employment. I understand that the arbitration agreement is available to me immediately so that I may have ample time to review and understand its terms.

Please Initial Here:

If you are applying to be a sprinkler apprentice please read this agreement. If you are hired you will be required to take part in the ABC apprentice program. Classes are held 2 nights a week for 3 hours at the HCC campus in Tampa. Classes begin in August of each year and follow the HCC community college calendar. We ask that all apprentices sign the following apprentice agreement.

Please Initial Here:

I have read and reviewed all of the attached job descriptions. I understand that if I am hired for any of these positions that I must be able to meet the requirements listed in order to perform my job. Failure to be able to meet the physical requirements of this job may result in forfeiture of employment.

Please Initial Here:

If employed, I agree to abide by all the work and safety rules of Piper Fire Protection. I understand that this company is committed to maintaining a drug free workplace. I am aware that the company may require a drug test as part of the hiring process. Also, if employed, I fully realize that the company may conduct annual random drug testing of its employees.

Digital Signature:

I understand that this application will remain on file for 30 days consideration. After 30 days, if I am still interested in a position with this company, it will be necessary for me to complete a new application form.

Date

Applicant Signature:

Date:

Services

Inspections

Construction

Design

Job Application

Step 1 of 2

Job Application

Educational History

High School Information

College Information

Former Jobs

1st Former Employer

2nd Former Employer

Character References

Position Information

Verify your Information

Equal Employment Opportunity