application

APPLICATION
 

Whitco Roofing is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status or any other legally protected status.

Name (Last, First, Middial Initial): *
Address Street: *
City: *
State: *
Zip Code: (5 digits)
Daytime Phone: *
Evening Phone:
Email:
Social Security Number:
Type of Position Desired: *
Are you Willing to Travel? yesno
Date Available: *
Salary Requirement: *
Highest Level of Education Completed:
Additional Education, Vocation, Professional Achievements, and/or Job Related Licenses or Memberships :
Do you have a Valid Drivers License? YesNo
What Computer Hardware/Software/Office Equipment Do You Have Profiency in?:
Employer Name: *
Employer Address: *
Employer Phone Number: *
Date Started: *
Last Date of Employment: *
Position Title: *
Salary: *
Description of Responsibilities:
Are you Still Employed? If No Provide Reason for Leaving. YesNo
Supervisor Name and Position: *
May we Contact YesNo
Employer Name: *
Employer Address: *
Employer Phone Number: *
Date Started: *
Last Date of Employment: *
Position Title: *
Salary: *
Description of Responsibilities:
Reason for Leaving: *
Supervisor Name and Title: *
 May we Contact? YesNo
Employer Name: *
Employer Address: *
Employer Phone Number: *
Date Started: *
Last Date of Employment: *
Position Title: *
Description of Responsibilities:
Salary: *
Reason for Leaving: *
Supervisor Name and Title: *
May we Contact? YesNo
1. Name and Relationship: *
Phone Number and Address: *
2. Name and Relationship: *
Phone Number and Address: *
3. Name and Relationship: *
Phone Number and Address: *
Have you Ever Been Convicted of a Felony? YesNo
If Yes, Set Forth the Nature and Dates of the Conviction, and Date of Release from Prison, if Applicable:
Please read the following statements carefully because they constitute conditions for employment with Whitco Roofing, Inc.

1. The information that I have provided on this application is accurate and true to the best of my knowledge. I understand that any misrepresentation or omission of fact on my application or during the interview process may result in the refusal of employment, withdrawal of job offer, or if employed, terminated from Whitco Roofing, Inc. employment.

2. The persons, schools, military services, current/prior employees names in this application, other organization including credit/law enforcement agencies and other persons having personal knowledge about me, are authorized by me to verify the information I have provided and to provide to Whitco Roofing, Inc. with information that it may request to arrive at an employment decision. I also authorize the procurement of an employment, education, driving record, and consumer credit report, and I understand that it may contain information about my background. I agree that a photocopy of this authorization shall be accepted with the same authority as the original. I hereby waive and release all persons, schools, current/prior employers, and other organizations from any liability arising from Whitco Roofing's reliance on the disclosure of any of the above information whether in writing or orally, and further waive and release Whitco Roofing, Inc. from any liability arising from reliance on the fore mentioned  information or the use, publication, or retention of such information within the context of its applicant review procedures.

3. I agree to protect Whitco Roofing's confidential information, trade secrets, and names or addresses of clients, and I will not disclose to Whitco Roofing, Inc. any confidential information from others.

4. Although Whitco Roofing, Inc. makes reasonable efforts to accommodate individual preferences, business needs may make the following conditions mandatory: overtime, shift work, a rotating schedule, or a work schedule that includes Saturday and/or Sunday. I understand and accept these as conditions of my employment.

5. In the event that I am employed, I agree to conform to Whitco Roofing's work rules, policies, and procedures. I understand that my employment is at will, that the terms and conditions of my employment can be changed at Whitco Roofing's option, and that my employment can be terminated with or without cause, at any
time, for any reason, at the option of the Company or myself.

6. I will be able, if hired, to certify that I am authorized to work in the United States of America, and understand that in accordance with Immigration Reform and Control Act that I will be required to provide timely documentation of employment eligibility.

7. Since it is the policy of Whitco Roofing Inc. to provide a safe, drug-free work place, all offers of employment are contingent upon the satisfactory completion of a drug screen conducted by an independent lab service chosen by Whitco Roofing. Any applicant that tests positive in a manner indicating alcohol or drug dependency will not be considered for employment unless proof is provided of the taking of prescription drugs and treatment under the direction of a licensed physician that can be related directly to the test result. 
Date: *
Signature of Applicant: *