Employment Application-English CAREERS Marina Plumbing Company Employment Application First Name* Last Name* Email Address* Home Phone*Cell Phone*Your Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long at present address? (Years / Months)* Previous Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long at previous address? (Years / Months) Are you over the age of 18?* Yes No How did you learn ab out our organization? Are you eligible for employment in the United States?* Yes No When will you be able to work? Are you employed now? Yes No Position Desired*Select One...Plumber ForemanJourneyman PlumberJourneyman InstallerApprentice PlumberLaborerOtherHave you physical defects which preclude you from performing certain jobs?* Yes No Please describe defects / limitation(s):* Employment History - Most Recent EmployerEMPLOYER #1 MOST RECENT EMPLOYERMost Recent Employer Company Name Most Recent Employer Address Street Address City State / Province / Region ZIP / Postal Code Employer Phone NumberSupervisor Job Title Job DescriptionEmployment Start Date and end Date Reason for Leaving Employment History - Previous EmployerEMPLOYER #2 - PREVIOUS EMPLOYERPrevious Employer Company Name Previous Employer Address Street Address City State / Province / Region ZIP / Postal Code Previous Employer Phone NumberSupervisor Job Title Job DescriptionEmployment Start Date and end Date Hourly Rate Reason for Leaving Employment History - Previous EmployerEMPLOYER #3 - PREVIOUS EMPLOYERPrevious Employer Company Name Previous Employer Address Street Address City State / Province / Region ZIP / Postal Code Previous Employer Phone NumberSupervisor Job Title Job DescriptionEmployment Start Date and end Date Hourly Rate Reason for Leaving Reference #1Reference #1 Name Reference #1 Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #1 Business Reference #1 Phone NumberYears Aquainted Reference #2Reference #2 Name Reference #2 Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Reference #2 Business Reference #2 Phone NumberYears Aquainted The information provided in this application for employment is true, correct and complete. If employed, any misstatements or omissions of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history, I authorize you to do so. If a report is obtained, you must provide, at my request, the name and address of the agency so I may obtain from them the nature and substance of information contained in the report.* I agree to the above conditions Δ
