Employment Main | H. D. Johnson

Application for employment

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, sexual orientation, citizenship status, genetic information or any other legally protected status.

Position's Applied For

Date of Applications

How Did You Learn About Us ?
Advertisement Employment Agency Relative Friend Inquiry Other

First Name

Middle Name

Last Name

Address

City

State

Zip

Telephone Number(s)

Best time to contact you at home is

If you are under 18 years of age, can you provide required proof of your eligibility to work ?
Yes No

Have you ever filed an application with us before ?
Yes No

Have you ever been employed with us before ?
Yes No

If yes, give date

Do any of your friends or relatives, other than spouse, work here ?
Yes No

Are you currently employed ?
Yes No

May we contact your previous employer ?
Yes No

Are you prevented form lawfully becoming employed in this country because of Visa or Immigration Status ? (Proof of citizenship or immigration status will be required upon employment) Yes No

Date available for work

What is your desired salary range ?

Are you available to work ?
Full Time Part Time Temporary

Please Indicate
Mornings Afternoon Evenings

Please Indicate dates available

Are you currently on "lay-off" status and subject to recall ?
Yes No

Can you travel if a job requires it ?
Yes No

After hours/evening availability some positions require on call rotation ?
Yes No

Are you available to work OT ?
Yes No

Are you available to work weekends ?
Yes No

Do you have a valid driver’s license ?
Yes No

Education

School	Name and Address of School	Course of Study	Number of years Completed	Diploma/Degree
High School
Undergraduate College
Graduate/Professional
Other (Specify)

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

Employer

Dates Employed (from)

Dates Employed (To)

Address

Work Performed

Job Title

Reason for leaving

Comments: Include explanation of any gaps in employment

Describe any specialized training, apprenticeship, skills and extra-curricular activities

Describe any job-related training received in the United States military

List professional, trade, business or civic activities and offices held You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status

Additional Information

Additional Information Other Qualification(Summarize special job-related skills and qualification acquired from employment or other experience)

Technical Skills
Installation and troubleshooting skills Finding or altering replacement parts Installing individual parts (pumps, pipes, etc.) Duct work installation (HVAC Mechanics) Use of Mobile Device (digital work tickets / work orders) Manual J and / or Manuel D Performing preventive maintenance Installation of bathroom/kitchen fixtures Certifications

State any additional information you feel may be helpful to us in considering your application

Note to Applicants: Do not answer this question unless you have been informed about the requirements of the job for which you are applying

Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation ?
Yes No

References

Name	Phone Number

Applicant's Statement

I certify that answer given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge, I understand, also, that i am required to abide by all rules and regulations of the employer.

Signature of Applicant

Date

This Application for Employment is sold for general use throughout the United States, Amsterdam Printing assumes no responsibility for the use of said form or any question which, when asked by the employer of the job applicant, may violate State and/or Federal Law.