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| Name: |
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| Address: |
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| City |
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| Zipcode: |
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| Telephone: |
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| Email: |
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| Social
Security #: |
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| 1.
Are you able to work 30-55 hours weekly, as required? |
YES |
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NO |
| 2.
Are you able to work Saturdays when required? |
YES |
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NO |
| 3.
Do you currently hold a State of Michigan Plumber’s
License? |
YES |
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NO |
| 4.
Do you currently hold a State of Michigan Mechanical License?
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YES |
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NO |
| Desired
starting wage per hour: |
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| High
School Attended: |
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| Graduated
from High School? |
YES |
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NO |
| Year
of Graduation: |
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| General
Course of Study (College Prep, Trade School, etc.) |
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| List
any diplomas, degrees, certificates or higher education you
have obtained. |
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| EMPLOYMENT
HISTORY |
| List
the last three jobs you have held, from most to least recent.
Include Company name, Address, Your Supervisor, Dates of Employment
and Reason for Leaving. |
| 1) |
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| 2) |
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| 3) |
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| PHYSICAL
QUALIFICATIONS |
| Are
you able to lift 100 lbs. repeatedly throughout the work day?
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YES |
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NO |
| Are
you able to work from an extension ladder, and on pitched
rooftops? |
YES |
|
NO |
| Are
you able to work outdoor in extreme heat and cold, rain and
snow? |
YES |
|
NO |
| MISCELLANEOUS |
Have
you ever been convicted of a crime? |
YES |
|
NO |
If
yes, explain:
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| Do
you have a valid Michigan Driver’s License? |
YES |
|
NO |
| Do
you currently have any points on your license? |
YES |
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NO |
If
yes, how many and for what offenses?
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| Submit
your information by clicking the "Submit Application"
button >> |
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