Job Application Personal Information Jump to Section Personal Information Position & Salary Education Experience Transporation References Additional Information Terms & Agreements Application Review Personal Information Position & Salary Education Experience Transporation References Additional Information Terms & Agreements Application Review Name * Email * Phone * Current Address 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 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 How Long Have You Lived at Your Current Address? Are You Over the Age 21? * Yes No What languages do you speak, read, or write? Position Applied For ... Project Manager Construction Technician Construction Project Manager Restoration Technician Apprentice Restoration Estimator Estimator Negotiator Restoration Technician Restoration Sales Representative Other Other Position Employment Desired ... Full-Time/Permanent Part-Time/Temporary Subcontractor Wages Desired * $ /hour How Many Hours can you Work Weekly? Are Nights Okay? Yes No Are Weekends Okay? Yes No Will you travel if the job requires it? Yes No Will you work overtime if asked? Yes No Are there any hours, shifts, or days you will not work? Yes No Please Explain What Date can You Start? High School College Business or Trade Employment Experience Employer Work Title Supervisor Address 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 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 Dates Salary $ /hour $ /hour Work Performed Reason for Leaving May we contact this Employer? Yes No Employer Phone Number Please identify any exceptions and reasons for not contacting prior employers Have you ever been dismissed or forced to resign from any employment? Yes No Please Explain Are you currently employed? Yes No Are you laid off and subject to recall? Yes No List all relevant years of experience in each category below: Project Management Lead Carpenter Drywall Hanging Siding Water Restoration Sales Estimating Framing Drywall Finishing Roofing Mold Remediation Customer Service Administrative Finish Carpentry Painting Doors/Windows Cleaning/Disinfection Clerical/Bookkeeping All applicable construction skills, training, and/or experience you have Significant jobs you have worked on Tools that you own and are willing to use on the job Do you have a valid driver’s license? Yes No Have you had your drivers license for at least 3 years or more? Yes No Type of License Operator (Standard) Commercial (CDL) State of Issue ... 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 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 Expiration Date What is your means of transportation to work? ... Full Size Pickup Full Size Van Car Small Truck/Minivan Do you have any accidents on record? Yes No How long ago was it? Have you received any tickets or moving violations? Yes No How long ago was it? Have you ever been cited for driving under the influence of alcohol or any banned substance? Yes No Please Explain Do you have any friends or relatives who work here? Yes No Please provide the name(s) and relationship(s) Character References List three (3) persons, NOT RELATED TO YOU, whom you have known at least one year. Name Address Phone Occupation Name Address Phone Occupation Name Address Phone Occupation Have you ever been convicted of a felony? Yes No Please Explain How did you hear of us? Have you applied here before? Yes No Please provide the previous date applied Have you been employed here before? Yes No Please provide the previous date employed Any Questions Relating to this Position? Applicant Drug Screen Acknowledgement As a job applicant, I freely and voluntarily agree to a urinalysis drug screen as part of my application for employment and I understand that a refusal to test, a positive confirmed drug test or a tampered with or an adulterated specimen will disqualify me from employment, even if I have started work pending the results of the drug test. I understand I am still completing the application process and will not officially be an employee until the company receives a negative pre-employment drug test result. If I am employed by this company, I understand and agree to abide by this company’s Drug Free Workplace policy, under applicable State law. I Agree to the Terms of the Drug Screening Process * Agreement (Please Read Carefully Before Submitting this Form) I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with R4 Restoration creates an actual or implied contract of employment. I understand that if I accept employment with R4 Restoration it will be on an at-will basis. This means that either R4 Restoration or I have the right to terminate the employment relationship at any time, for any reason, with or without cause. I agree to submit to drug and alcohol testing, if requested by R4 Restoration I release R4 Restoration, and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. I authorize R4 Restoration to investigate information concerning my education, credit history, employment experiences and all other aspects of my background relevant to my proposed employment. I release R4 Restoration and its employees from all liability arising from such investigation. I Agree to the Terms of this Employment Agreement * Not Even Previous Step Next Step R4 Restoration is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure that opportunity for employment with R4 Restoration depends solely on your qualifications.
