Section 1- Personal Information
Name:
Email:
Address:
City:
State:
Zip:
Phone:
Date of Birth:
Social Security Number:
Drivers License Number and Expiration Date:
Section 2- Experience
Most Recent Employer and Position:
From:
To:
Reason for Leaving:
Previous Employer and Position:
From:
To:
Reason for Leaving:
Years in Roofing:
Residential:
Commercial:
Most Recent Hourly Wage:
Indicate Systems(s) You Have Installed:
Shingles:
Yes:
Slate & Tile
Yes:
Waterproofing
Yes:
Single Ply
Yes:
Thermo Plastic
Yes:
Asphalt Bur
Yes:
Modified Bitumin
Yes:
Coal Tar
Yes:
Sheet Metal
Yes:
At what system are you best?
What are your career goals?
Indicate any other skills you have in addition to roofing:
Indicate any formal training or seminars you have completed:
Have you ever been certified to do asbestos abatement?
Yes:
No:
If no, are you willing to be certified?
Yes:
No:
How many days do you typically work in one week?
Section 3- Background Information
Highest Grade of School Completed:
Do you have a valid drivers license?
Yes:
No:
Do you have a CDL license?
Yes:
No:
Do you currently belong to a union?
Yes:
No:
Union:
Classification:
Do you have reliable transportation?
Yes:
No:
Have you ever been arrested?
Yes:
No:
If so, please explain:
Are you currently unemployed?
Yes:
No:
Are you collecting unemployment compensation?
Yes:
No:
Reason for seeking new employment:
Do you consent to drug testing as a pre-condition of employment?
Yes:
No:
Please give the name and phone number of an employer reference:
Do you consent to a state police background check as a pre-condition of employment?
Yes:
No:
In the event you are hired, do you agree to comply with every aspect of the Phoenix Roofing, Inc. safety policy?
Yes:
No:
By typing my electronic signature below, I attest that the information above is true and factual to the best of my knowledge and belief.
Emergency Information:
Contact:
Relationship:
Phone:
Name:
Date: