Southeast Restoration Group

Southeast Restoration Group
Application For Employment

Applications are received and employees are hired without regard to race, creed, religion, color, sex, age, national origin, marital status, citizenship, or physical or mental disability. In addition, we encourage the employment of veterans. The receipt of this application does not mean that job openings exist and does not obligate us in any way. We appreciate your interest in our organization.

AN AAP/ EQUAL OPPORTUNITY EMPLOYER -- DRUG FREE WORKPLACE

PERSONAL INFORMATION

Date:

Name: Social Security # XXX-XX- Date of Birth
Last First Middle initial

Present Address:
No. Street Name Building No. City State Zip Code

Previous Address:
No. Street Name Building No. City State Zip Code

Telephone: Cell Phone: Email Address:

Valid Driver's License # Expiration Date: State:
Do you own a reliable vehicle? Yes No
Do you currently use tobacco products? Yes No

Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of offense, seriousness and nature of violation, rehabilitation and position applied for will be taken into account.

Are you currently on probation? Yes No
Have you ever pled "guilty" or "no contest" to, or been convicted of a crime? Yes No
if yes, please provide city, state, date(s) and details below.

EMPLOYMENT INFORMATION

EDUCATION INFORMATION

Position applying for
Expected salary
Date available for work
Employment type: Full-time Part-time Temporary
If part-time, what days? hours?
Are you employed now? Yes No
May we contact your employer? Yes No

Have you ever served in the Military Service Yes No
Number of years in service
Rank
Branch

Did you graduate H.S.? Yes No
If no, highest grade completed
Name of High School attended:

	Name	Degree	Graduate?
Trade\ Business School			Yes No
			Yes No
			Yes No

College\ University			Yes No
			Yes No
			Yes No

PAST EMPLOYMENT SECTION

LIST BELOW PRESENT AND PAST EMPLOYMENT BEGINNING WITH YOUR MOST RECENT

1.	From: (Mo/Yr) To: (Mo/Yr) Position Held:	Name and address of company:	Supervisor: Telephone:	Start rate: Last rate:
			Reason for leaving:
2.	From: (Mo/Yr) To: (Mo/Yr) Position Held:	Name and address of company:	Supervisor: Telephone:	Start rate: Last rate:
			Reason for leaving:
3.	From: (Mo/Yr) To: (Mo/Yr) Position Held:	Name and address of company:	Supervisor: Telephone:	Start rate: Last rate:
			Reason for leaving:

How many employers have you had in the past ten(10) years?
May we contact the Employers listed above? Yes No
If not, indicate by number which ones you do not wish us to contact:

Please check all areas for which you have experience:

Yes No Stucco Repair	Yes No Cementicious Coatings
Yes No Caulking (2-part material)	Yes No Carbon Fiber Installations
Yes No Painting (Commercial)	Yes No Tuck Pointing
Yes No Elastomeric Wall Coatings	Yes No Working on Swing Stages
Yes No Urethane Deck Coatings	Yes No High Reach Equipment
Yes No Below Grade Sheet Membrane	Yes No Hopper Gun
Yes No Below Grade Liquid Membrane	Yes No Compressors
Yes No Metallic Iron	Yes No Sand Blast Equipment
Yes No Bentonite Panels	Yes No Spray Equipment
Yes No Expansion Joint Restoration	Yes No Roof Repairs
Yes No Concrete Repairs	Yes No Concrete Finishing
Yes No Epoxy Injection	Yes No Concrete Patch Repair
Yes No Form Work (Carpenter Skills)	Yes No Single Ply Roofing

Would you be able to perform the above duties on a daily basis if needed?	Yes No
Have you ever been responsible for or overseen a job in which you supervised other men?	Yes No
How many men have you supervised?
Briefly describe your past job experiences and responsibilities:
Briefly describe any special skills you may have, including equipment certifications:

I certify that this application is true to the best of my knowledge and that falsified information will be grounds for termination. I authorize investigation of all statements and references listed above. I understand that, if hired, my employment is for no definite period and may be terminated at any time without prior notifications. (sign & date below)

APPLICANT SIGNATURE: DATE:
(sign by entering your full name)

Southeast Restoration Group Application For Employment

Southeast Restoration Group
Application For Employment