Paul's Termite and Pest Control, Inc. - Application for Employment

PERSONAL INFORMATION

1. * First Name:
2. * Last Name:
3. * Email Address:
4. Daytime Phone: (###) ###-####
5. Evening Phone: (###) ###-####
6. Address:
7. Address:
8. City:
9. State: Please Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
10. Zip Code:
11. Social Security Number: 000-00-0000

EDUCATIONAL BACKGROUND

Grammar or High School

1. Did you Graduate? Yes No
2. Years Attended:
3. Degree Received and Major Subject:
4. * School Name:
5. * Location:

Trade, Business or Vocational

1. Did you Graduate? Yes No
2. Years Attended:
3. Degree Received and Major Subject:
4. School Name:
5. Location:

College

1. Did you Graduate? Yes No
2. Years Attended:
3. Degree Received and Major Subject:
4. School Name:
5. Location:

Graduate School

1. Did you Graduate? Yes No
2. Years Attended:
3. Degree Received and Major Subject:
4. School Name:
5. Location:

SPECIAL SKILLS AND QUALIFICATIONS

1. * Do you have any special skills, training, or experience that might help you qualify for a position at this company? Yes No
2. If Yes, please explain:
3. * List any professional, trade business, or civic activities or offices held that would relate to the work here.
4. * What foreign languages do you fluently speak, read, and/or write that would relate to the work here?

MILITARY SERVICE

1. Branch of Service:
2. Rank at discharge, if applicable:
3. List duties and special training:
4. * Were you honorably discharged? Yes No
5. If no, please explain:

WORK HISTORY

Please list your most recent job first.

1. * EMPLOYER #1:
2. * Dates employed: From To
3. * Address:
4. * Phone:
5. * Supervisor's Name:
6. * Job Title:
7. * Hourly Rate/Annual Salary: Starting Final
8. * Still Employed Resigned Terminated
9. Reason for leaving, if applicable:

1. EMPLOYER #2:
2. Dates employed: From To
3. Address:
4. Phone:
5. Supervisor's Name:
6. Job Title:
7. Hourly Rate/Annual Salary: Starting Final
8.   Resigned Terminated
9. Reason for leaving:

1. EMPLOYER #3:
2. Dates employed: From To
3. Address:
4. Phone:
5. Supervisor's Name:
6. Job Title:
7. Hourly Rate/Annual Salary: Starting Final
8.   Resigned Terminated
9. Reason for leaving:

GENERAL INFORMATION

1. What position(s) are you applying for?
2. What is your salary expectation? $
3. When can you start work? /(Date)
4. How were you referred to us?
5. Are there any days or times during the week that you are not available to work? Yes No
6. If yes, please list the day/times you are not available to work:
7. Are you willing to work overtime? Yes No
8. Are you at least 18 years old? Yes No
9. Are you willing to travel? Yes No
10. Do you have steady transportation to work? Yes No
11. Are you employed now? Yes No
12. May we contact your current employer? Yes No
13. Are you legally eligible to work in the United States? Yes No (Proof of citizenship status/identity required upon hire.)
14. Do you hold a valid driver's license? Yes No
15. If yes, provide the license number:
16. Have you had any moving violation(s) or accidents in the last three years? Yes No
17. If yes, give date(s) and explanation of each:
18. Have you ever been convicted of or have you ever received a sentence for a crime(s) other than a minor traffic violation? Yes No
19. If so, for each, list type of conviction/sentence, date of the offense, court, and place where the offense occurred:

Paul's Termite and Pest Control, Inc. Agreement and Release Information

EQUAL EMPLOYMENT OPPORTUNITY
This is a drug-free workplace offering equal employment opportunities. We do not discriminate on the basis of race, creed, color, sex, religion, age, national origin, disability, citizenship status, veteran status, or any other class protected by state, county, local, or federal regulations.

By entering you name you are submitting your digital signature.

1. Signature:
2. Date of Birth: (mm/dd/year)

Paul's Termite and Pest Control, Inc. is a EEOC compliant company, your date of birth will only used for the purpose of a background check and will not reflect any employment decision made.

1. As an added security feature, please enter the security code shown above: