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Your Information

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

Position(s) Applying For:*

How did you learn about this opening?

Expected Salary*

Have you applied for a position with us before?

No
Yes

If yes, specify date:

Have you ever been employed with us before?

No
Yes

If yes, specify date & position:

Are you currently employed?

Yes
No

On what date would you be available for work?

What are you available to work?

Can you travel for work if necessary?

Yes
No

Are you legally permitted to work in the US?*

Yes
No

Are you 18 years of age or older?*

Yes
No

Are you related to anyone who works at Southwestern Remodeling?

Yes
No

Please note employee’s name and relationship to the individual:

Have you been convicted of a felony within the last seven years?*

No
Yes

NOTE: Such conviction does not necessarily prevent you from employment.

If yes, please explain:

Are you willing to take drug tests?

Yes
No

Education

High School/Other:

Graduation Date:

College:

Years Attended/Graduation Date:

Other Training/Education:

Please list any industry-specific skills and certifications:

Military Service

Have you ever served in the United States military?*

No
Yes

What was the length of your military service?

In years and months

What was your rank at time of discharge?

What type of training and work experience did you receive while in the military?

Employment History

Most Recent Employer

Employer:

Address:

Phone:

Starting Date:

Starting Pay:

Starting Position:

Ending Date:

Ending Pay:

Ending Position:

Supervisor:

May we contact the employer?

Please list the jobs held, duties performed, skills used or learned, and advancements or promotions while you worked at the company:

Employer #2

Employer:

Address:

Phone:

Starting Date:

Starting Pay:

Starting Position:

Ending Date:

Ending Pay:

Ending Position:

Supervisor:

May we contact the employer?

Please list the jobs held, duties performed, skills used or learned, and advancements or promotions while you worked at the company:

Employer #3

Employer:

Address:

Phone:

Starting Date:

Starting Pay:

Starting Position:

Ending Date:

Ending Pay:

Ending Position:

Supervisor:

May we contact the employer?

Please list the jobs held, duties performed, skills used or learned, and advancements or promotions while you worked at the company:

References

Reference #1

Name:

Phone:

Years Known:

Reference #2

Name:

Phone:

Years Known:

Applicant's Statement

I certify that the information provided in this application is true, to the best of my knowledge.

I understand that providing false or misleading information at any time during the application and interview process may lead to refusal to hire or discharge from Southwestern Remodeling. If I become employed by Southwestern Remodeling, I agree to follow all rules and regulations of Southwestern Remodeling as they develop and change.

I allow Southwestern Remodeling to conduct investigations on me, my background, and my performance and am aware that such investigations will become a part of my employment record. With this, I authorize Southwestern Remodeling to speak with acquaintances, personal and professional, to gather information about me.

I authorize all former employers and references to provide any information about me to Southwestern Remodeling and release them of liabilities and damages of all kinds for providing this information. I authorize Southwestern Remodeling to verify the accuracy of the information within this application. I also authorize the release of my educational transcripts to Southwestern Remodeling for education verification purposes.

I release Southwestern Remodeling from liability for collecting information about me and using it to make employment decisions. If I become employed by Southwestern Remodeling, I understand that the employment relationship will be “at-will,” and that the “at-will” status may not change at any time unless specifically approved, in writing, by the President of Southwestern Remodeling.

I agree that if I become indebted to Southwestern Remodeling, I will be responsible for repaying the total owed upon termination from the Company. If I do not repay the sum prior to my final paycheck being received, the money owed will be deducted from my pay.

This application for employment is valid for the next 90 days. I understand that if I wish to be considered for employment after this period of time, I must apply again.

Please select the following:*

I accept the Southwestern Remodeling employment agreement.
I do not accept.

Note: Selecting “I accept” and submitting this application signifies you agree to the applicant statement.

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Your Information

Education

Military Service

Employment History

Most Recent Employer

Employer #2

Employer #3

References

Reference #1

Reference #2

Applicant's Statement

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