APPLICANT INFORMATION

• Last Name
• First Name
• Middle Name
• Street Address
• Apartment/Unit #
• City
• State
• ZIP
• Phone
• Email Address
• Position Applied for
• Are you able/willing to travel? YesNoIf NO (optional)
• Are you authorized to work in the U.S? YesNoIf NO (optional)
• Have you ever worked for this company? YesNoIf so, when?
• Do you have a valid license? YesNoIf yes, what class
• How did you learn about this employment opportunity?
  Job Posting on:Hays Has JobsKansasWorksNext-TechOtherEmployee Referral

EDUCATION

• High School
• Address
• Did you graduate?YesNo
• College
• Address
• Did you graduate?YesNo
• Other
• Address
• Did you graduate?YesNo

• TOOLS & MACHINE OPERATION: PLEASE LIST ALL TOOLS AND MACHINES YOU ARE KNOWLEDGEABLE AT OPERATING. INCLUDE ANY CERTIFICATIONS YOU MIGHT HAVE OBTAINED IN THE PAST.

Previous Employment

• Company
• Phone
• Address
• Supervisor
• Job Title
• Starting Wage $
• Ending Wage $
• Responsibilities
• Reason for leaving
• May we contact your previous supervisor for a reference?YesNo

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• Company
• Phone
• Address
• Supervisor
• Job Title
• Starting Wage $
• Ending Wage $
• Responsibilities
• Reason for leaving
• May we contact your previous supervisor for a reference?YesNo

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• Company
• Phone
• Address
• Supervisor
• Job Title
• Starting Wage $
• Ending Wage $
• Responsibilities
• Reason for leaving
• May we contact your previous supervisor for a reference?YesNo

References

Please list three professional references. DO NOT INCLUDE FAMILY MEMBERS OR FRIENDS.
• Full Name
• Relationship
• Company
• Phone
• Address

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• Full Name
• Relationship
• Company
• Phone
• Address

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• Full Name
• Relationship
• Company
• Phone
• Address

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.

I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize Roofmasters Roofing & Sheet Metal Co., Inc. to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full responses to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of Roofmasters Roofing & Sheet Metal Co., Inc. serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. I understand that the first SIX MONTHS of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.

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