Grand Lake Plumbing

Grand Lake Plumbing & Heating Employment Application

Your information will be kept in strict confidence and will not be shared with any third party.

* Indicates Required Fields

Contact Information
* Full Name
* Street Address
Apartment/Unit/Lot
* City
* State
* Zip Code
* Primary Phone
Phone 2
E-mail


Preferred Method of Contact Select all that apply E-mail Mobile Phone Home Phone Mail
Applicant Information
Date Available
Desired Salary
* Desired Position
Are you a citizen of the United States? yes no
If no, are you authorized to work in the U.S.? yes no
Have you ever worked for this company before? yes no
If yes, when?
Have you ever been convicted of a crime? yes no
If yes, please explain

Education
High School
Name of High School
School Address
Dates Attended
Did you graduate? yes no
College
Name of College
College Address
Dates Attended
Did you graduate?	yes no
Degree
Other School 1
Name of School
School Address
Dates Attended
Did you graduate?	yes no
Course of Study
Other School 2
Name of School
School Address
Dates Attended
Did you graduate?	yes no
Course of Study


References
Please list two professional references.
Reference 1
Full Name
Relationship
Company
Phone
Street Address

Reference 2
Full Name
Relationship
Company
Phone
Street Address


Previous Employment
Most Recent Job
Company
Phone
Street Address

Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Please describe.
Dates employed
Reason for leaving
May we contact your supervisor for a reference? yes no
Previous Job 2
Company
Phone
Street Address

Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Please describe.
Dates employed
Reason for leaving
May we contact your supervisor for a reference? yes no
Previous Job 3
Company
Phone
Street Address

Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Please describe.
Dates employed
Reason for leaving
May we contact your supervisor for a reference? yes no
Military Service
Branch
Dates of Service
Rank at Discharge
Type of Discharge
If other than honorable discharge
Please describe.
Questions for Potential Residential Workers
Do you have a current valid driver's license? yes no
Driver's license number
Are there any restrictions to your driver's license?
Please explain.
Do you have other endorsements to your driver's license, such as Chauffeur or CDL?
Please list all.
Do you have reliable transportation to get you to and from work on a daily basis? yes no
Are you currently working in the service industry? yes no
Why are you interested in the service industry? Please explain.
What is your previous experience in the service industry?
Please explain.
Where do you see yourself in 2 years – Personally? Occupationally?
Please explain.
Do you have any residential/service work experience? yes no
Do you have any knowledge of Hydronic Heating? yes no
Do you have a Journey or Master Plumbers License? yes no
Plumbers License Number
If no, are you registered as an apprentice? yes no
Have you had any formal training with State Plumbing Codes? yes no
Do you have any manufacturers certifications, such as PEX water piping or corrugated stainless steel gas piping?
Please list all.
Do you have your own hand tools? yes no
If no, would you be willing to provide your own hand tools? yes no
Disclaimer / Submit
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.