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Dear Applicant:
Please read the following statement prior to applying for a position at Vincentini Plumbing. You will be asked to agree to this statement when submitting your employment application. If you have any questions regarding the following statement, please let us know.
I hereby certify that the information contained within the employment application that I am submitting to Vincentini Plumbing is true and complete to the best of my knowledge. I understand that information omissions or falsification of this application in any detail may result in my disqualification from consideration for employment or dismissal from employment.
I also understand that my employment is subject to a satisfactory check of my references. I give Vincentini Plumbing the right to investigate the information given, and to secure additional information if necessary. I authorize my previous employers, educational institutions, and all other individuals and organizations listed on my employment application to provide information regarding my employment, work habits and character.
I agree that Vincentini Plumbing and my previous employers, educational institutions and all other individuals and organizations listed on my application will NOT be held liable in any respect if an employment offer is not made, is withdrawn, or my employment is terminated because of misrepresentations or omission of requested information.
I understand that depending on the position that I am applying for, I might be asked to provide a valid driver’s license, to undergo a drug screen, and a background check. I will be required to immediately furnish documentation establishing my identity and eligibility to be legally employed in the United States.
Employment At-Will
I understand that employment at Vincentini Plumbing (“the Company”) is an employment at-will. Employment at-will may be terminated at the will of either I or the Company. Employment may be terminated with or without cause at any time by myself or by the Company. Terms and conditions of employment with the Company may be modified at the sole discretion of the Company with or without cause and with or without notice.
Vincentini Plumbing, is an equal opportunity employer, and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, genetic information, or veteran status.
Applicant's Signature
Date
Name(Last Name First)
Email
Date
Referred by:
Permanent Address
City
State
Select a State
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
Zip Code
Primary Telephone Number
Secondary Telephone Number
Currently Employed
Currently Employed?
Yes
No
Have you ever applied to Vincenti plumbing before?
Have you ever applied to Vincenti plumbing before?
Yes
No
Have you ever applied to Vincenti plumbing before?
Can we contact your current employer?
Can we contact your current employer?
Yes
No
Can we contact your current employer?
Previous Application Date
Position Desired:
Minimum Salary/Hourly required
Date Available to Start:
Former Employers (List Current or Last Employer First)
Dates Month/Year (From-To)
Employer's Name
Salary/Hourly
Position
Reason for Leaving
Dates Month/Year (From-To)
Employer's Name
Salary/Hourly
Position
Reason for Leaving
Dates Month/Year (From-To)
Employer's Name
Salary/Hourly
Position
Reason for Leaving
Training/Military Service/Special Skills/Awards:
US Military Training in any of the Armed Forces
Rank:
Special Training:
Special Skills:
10 Hour OSHA:
30 Hour OSHA:
Med Gas Certification:
Grade 6 Water Operator:
Sewer Layer card:
Awards/Certificates/Licenses (Licenses Held)
License Number
Expiration Date:
EDUCATION:
Type of School
College
Name & Location of School
Years Attended
Graduated (Yes/No)
Subjects Studied
Trade or Business
Name & Location of School
Years Attended
Graduated (Yes/No)
Subjects Studied
High School/Trade School
Name & Location of School
Years Attended
Graduated (Yes/No)
Subjects Studied
References: Two Professional and One Personal (Must have professional references)
Name
Business
Contact Information
Relationship
Years Known
Name
Business
Contact Information
Relationship
Years Known
Name
Business
Contact Information
Relationship
Years Known
Are you able to perform all the physical aspects of the position that you are applying for as such lift 50 lbs., bend, stretch, stand for extend perio
Yes
No
Do you have a valid driver's license?
Yes
No
Have you ever been convicted of a crime?
Yes
No
(if yes, please explain) Use additional space if need be.
Certification:
I certify that the facts contained in this application are true and complete to the best of my knowledge, and understand that if employed, falsified statements on this application shall be grounds for dismissal. In compliance with Federal Law, all persons hired will be required to verify identity and eligibility to work in the United States, and to complete the required employment eligibility verification documents upon hire. I authorize the investigation of all statements contained herein, and the references and employers listed above to give you any, and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also, understand that this is a drug-free company, and I will be randomly selected to be tested. I understand that the state of Nebraska is At-Will State. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA), and Health Insurance Portability and Accountability Act (HIPAA).
Signature
Date
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