Service Technician Application

Transcription

1 Service Technician Application 2015

2 Application For Service Technician Williams Plumbing & Drain Service All applicants are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, physical or mental disability, or any other legally protected status. Williams Plumbing & Drain Service is an Equal Opportunity Employer. Personal Information Last Name First Name Middle Name Current Address City State Zip Code Phone Number Social Security Number - - Date of Birth Age Are you a U.S. citizen? Yes No (The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.) In the last three years, do you have any moving violations on your driver s record? Yes No If yes, list the year and incident. Have you been convicted of a felony or misdemeanor within the last 5 years? Yes No (Criminal convictions are not an absolute bar to employment, but will be considered only in relation to specific job requirements) If yes, please describe: Plumber Classification Please check all that apply: Journeyman Apprentice Contractor (Active) Contractor (Inactive) No License State of Oklahoma City of Tulsa City of Broken Arrow Other

3 Work Experience Please rate your experience level on the following list: Please circle numbers as they apply. Check the tool column if you own the tools to complete the job. General Repair - Residential General Repair - Commercial Commercial Water Heaters / Boilers Tankless Hotwater Heaters Gas Water Heaters Electric Water Heaters Main Sewer Stoppages Toilet Stoppages Small Drain Stoppages Gas Lines Sewer Line Camera Equipment Provided Slab Leak Detection Provided Slab Leak Repairs- Sewer Slab Leak Repairs - Water Sewer Line Repairs Sewer Line Replacements Water Line Repairs Water Line Replacements Bore Machine Provided Jetter Service Provided Remodels Shower Pans From the above list, pick your top five preferred jobs Expert No Experience Tools

4 Education I have graduated high school or have equivalent GED. Yes No (if yes, please provide name and location) High School Name: Location: I have graduated from college. Yes No If partially completed please list semesters finished: College Name: Degree: I have graduated from trade school. Yes No If partially completed please list time completed: Trade School Name: Trade Studied: Employment History Date you can start Rate desired Are you currently employed? Yes No If yes, may we contact your employer? Yes No Current Employer s Name Phone Have you applied here before? Yes No If yes, when? Past Employment 1. Name Address Phone Position Reason for Leaving Employed from to Starting Rate Ending Rate 2. Name Address Phone Position Reason for Leaving Employed from to Starting Rate Ending Rate 3. Name Address Phone Position Reason for Leaving Employed from to Starting Rate Ending Rate

5 Emergency Contact Last Name First Name Relation Current Address City State Zip Code Phone Number References Reference One Phone Years Known Reference Two Phone Years Known Reference Three Phone Years Known Are you capable of performing the essential functions of a service technician as they have been outlined to you? Yes No If not, you should advise us what functions you cannot perform and whether you believe you require an accommodation in order to perform the function(s). I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that if employed, and have lied or falsified statements on this application I may be dismissed. I authorize that I will willingly sumit to a drug test prior to employment. I authorize investigation of all statements contained in this application and the references listed above. I release all parties from all liability from any damage that may result from furnishing any and all information, personal or otherwise, concerning my previous employment. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.