SHERIFF PLUMBING
Employment Application

APPLICATION INFORMATION

Date:
Last Name: First: M.I.:
Address: Apt #:
City: State: Zip Code:
Phone:
( )   -
Email:
Position Applied For:
Date Available: Desired Salary:
Social Security No.:
Are you a citizen of the U.S.:
Yes No
If no, are you authorized to work in the U.S.?
Yes No
*Have you ever worked for this company:
Yes No
If so, when?
Have you ever been convicted of a felony:
Yes No
If yes, explain

EDUCATION

High School:
Address:
Date From: To:
Did you Graduate?:   Degree:
College:
Address:
Date From: To:
Did you Graduate?:   Degree:
Other School:
Address:
Date From: To:
Did you Graduate?:   Degree:

REFERENCES

Please list three professional references

Full Name: Relationship:
Company:
Phone:
( )   - Ext.
Address:
Full Name: Relationship:
Company:
Phone:
( )   - Ext.
Address:
Full Name: Relationship:
Company:
Phone:
( )   - Ext.
Address:

EMPLOYMENT HISTORY

Company: Supervisor:
Phone:
( )   - Ext.
Address:
Job Title:
Starting Salary: Ending Salary:
Responsibilities:
From: To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Contact Supervisor:  
Company: Supervisor:
Phone:
( )   - Ext.
Address:
Job Title:
Starting Salary: Ending Salary:
Responsibilities:
From: To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Contact Supervisor:  
Company: Supervisor:
Phone:
( )   - Ext.
Address:
Job Title:
Starting Salary: Ending Salary:
Responsibilities:
From: To:
Reason for Leaving:
May we contact your previous supervisor for a reference?
Contact Supervisor:  

MILITARY SERVICE

Branch:
From: To:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview my result in my release.

By inserting my full name and initials below, I hereby confirm I am the person named on this application.
*Full Name:
*Initials:
*Date: