Applicant Name
Address
State
Zip Code
Apt#
Date Available to Start
Social Security Number
Phone Number
Cell Phone
Email
Position Desired
How Did You Learn About Job Opportunities with Flat Rate Plumbing?
Availabilty
Are you interested in a full-time or part-time position?
Full Time
Part Time
Please check your availability.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Are you able to meet the attendance requirements?
Yes
No
Do you have any objection to working overtime if necessary?
Yes
No
Have you ever been convicted of a crime in the last 7 years?
Yes
No
If yes, please explain
Can you submit proof of legal employment authorization and identity?
Yes
No
If you are under 18, can you furnish a work permit if it is required?
Yes
No
Have you ever been previously employed by our organization?
Yes
No
Previous Employer
Dates of Employment
Position
Pay Rate
Business Name
Business Phone
Supervisors Name
Reason for Leaving
Other Skills and Qualifications
Education
High School
College/University
Technical Training
Reference
Reference #1
Phone Number 1
Reference #2
Phone Number 2
Reference #3
Phone Number 3