Employment

Name(Required)

First Middle Last

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Phone(Required)

Your Email Address(Required)

Enter Email Confirm Email

List any other names used if different from name on this application.

What is your date of birth?(Required)

Do you have a current valid driver’s license?(Required)

Yes

No

If yes, what state issued it and what class of license do you have?

List all traffic violations received in the past 3 years and briefly describe each:(Required)

Have you ever been convicted of a felony or subjected to a deferred adjudication on a felony charge?(Required)

Yes

No

Have you been convicted of a Class A or B misdemeanor in the last 20 years?(Required)

Yes

No

If your answer is “Yes," explain in concise detail, giving the dates and nature of the offense, the name and location of the court, and the disposition of the case(s).

A conviction may not disqualify you, but a false statement will. Note: Some state agencies may require additional information related to convictions of misdemeanors.

If your answer is “Yes,” explain in concise detail, giving the dates and nature of the offense, the name and location of the court, and the disposition of the case(s).

A conviction may not disqualify you, but a false statement will. Note: Some state agencies may require additional information related to convictions of misdemeanors.

EDUCATION

(NOTE: Applicants may be required to provide proof of diploma, degree, transcripts, licenses, certifications, and registrations.)

Did you graduate from high school?(Required)

Yes

No

Indicate Highest Grade Completed(Required)

If you did not graduate from high school, did you receive a GED?

Yes

No

Schools, Colleges, & Universities

Name & Location of School

Dates Attended

MM/YY to MM/YY

Date of Graduation

or expected graduation

Sem/Clock Hours Completed

Type of Diploma or Degree

Major/Minor Fields of Study

Special Training/Skills/Qualifications

List all job-related training or skills you possess and machines or office equipment you can use, such as calculators, printing or graphics equipment, computer equipment, types of software, and hardware.

Name & Location of School

Dates Attended

MM/YY to MM/YY

Date of Graduation

or expected graduation

Sem/Clock Hours Completed

Type of Diploma or Degree

Major/Minor Fields of Study

Special Training/Skills/Qualifications

List all job-related training or skills you possess and machines or office equipment you can use, such as calculators, printing or graphics equipment, computer equipment, types of software, and hardware.

Name & Location of School

Dates Attended

MM/YY to MM/YY

Date of Graduation

or expected graduation

Sem/Clock Hours Completed

Type of Diploma or Degree

Major/Minor Fields of Study

Special Training/Skills/Qualifications

List all job-related training or skills you possess and machines or office equipment you can use, such as calculators, printing or graphics equipment, computer equipment, types of software, and hardware.

Have you ever been employed by Jasper Plumbing Services, LLC?(Required)

Yes

No

If yes, please list the dates of your employment

MILITARY SERVICE

(A copy of a report of separation from the Armed Services may be required.)

Are you a veteran?(Required)

Yes

No

If yes, list type of discharge status:

Beginning Date of Service

End Date of Service

Please list all continuing education certificates you currently hold:

Course Title

Date

Course Number

School Number

Course Title

Date

Course Number

School Number

Course Title

Date

Course Number

School Number

Course Title

Date

Course Number

School Number

Employment History

This information will be the official record of your employment history and must accurately reflect all significant duties performed. Summaries of experience should clearly describe your qualifications. 1. Include ALL employment. Begin with your current or last position and work back to your first. 2. Employment history should include each position held, even those with the same employer. 3. EMPLOYER ADDRESS MUST BE COMPLETE MAILING ADDRESSES, INCLUDING ZIP CODE. 4. Give a brief summary of the technical and, if appropriate, the managerial responsibilities of each position you have held. 5. For supervisory/managerial positions, indicate the number of employees you supervised.

Position #1

Employer(Required)

Mailing Address(Required)

City & State Zip(Required)

Employer's Phone Number(Required)

May we contact?(Required)

Yes

No

Start Date(Required)

End Date(Required)

Position Title(Required)

Type(Required)

Full-Time

Part-Time

Summer

Temp/Project

If Part-Time: average # of hours worked per week(Required)

Current/Final Salary(Required)

Role(Required)

Technical

Non-Managerial

Supervisory Managerial

If supervisory: # of employees you supervised(Required)

Immediate Supervisor(Required)

Name & Title

Supervisor Phone Number(Required)

(xxx) xxx-xxxx

Summary of Experience(Required)

Specific reason for leaving(Required)

Position #2

Employer(Required)

Mailing Address(Required)

City & State Zip(Required)

Employer's Phone Number(Required)

May we contact?(Required)

Yes

No

Start Date(Required)

End Date(Required)

Position Title(Required)

Type(Required)

Full-Time

Part-Time

Summer

Temp/Project

If Part-Time: average # of hours worked per week(Required)

Current/Final Salary(Required)

Role(Required)

Technical

Non-Managerial

Supervisory Managerial

If supervisory: # of employees you supervised(Required)

Immediate Supervisor(Required)

Name & Title

Supervisor Phone Number(Required)

(xxx) xxx-xxxx

Summary of Experience(Required)

Specific reason for leaving(Required)

Position #3

Employer(Required)

Mailing Address(Required)

City & State Zip(Required)

Employer's Phone Number(Required)

May we contact?(Required)

Yes

No

Start Date(Required)

End Date(Required)

Position Title(Required)

Type(Required)

Full-Time

Part-Time

Summer

Temp/Project

If Part-Time: average # of hours worked per week(Required)

Current/Final Salary(Required)

Role(Required)

Technical

Non-Managerial

Supervisory Managerial

If supervisory: # of employees you supervised(Required)

Immediate Supervisor(Required)

Name & Title

Supervisor Phone Number(Required)

(xxx) xxx-xxxx

Summary of Experience(Required)

Specific reason for leaving(Required)

Resume

Include information about jobs or projects you worked in a separate document and upload here.

Upload Your Resume

Upload your resume in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

Terms and Conditions(Required)

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR UNDERSTANDING AND ACCEPTANCE BY AGREEING TO OUR TERMS AND CONDITIONS

1. I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination.

2. I understand that completion of this Application for Employment does not guarantee that I have been employed by this Company. I understand that all job offers may be conditional upon satisfactory completion of a background check, criminal history check, drug screen, and physical exam. I hereby consent to all of these tests and checks. I further understand that final approval of any job offer is made by the Company after completion of these tests and that until such final approval is made, I do not have a firm job offer to work as an employee of the Company.

3. I understand that all employees are employed at the will of the Company for an indefinite period and are subject to termination at any time, for any lawful reason, with or without cause or notice. At the same time, I understand that I may terminate my employment at any time and for any reason. I understand that no representative of the Company, other than the President, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.

4. I understand that within 3 days of starting employment with the Company, I will have to provide valid documents that verify my identity and my eligibility to legally work in the United States. If I do not provide such documentation by the third day of employment, I understand that my employment will be terminated.

5. I understand that Jasper Plumbing Services, LLC will check with the Texas Department of Public Safety, the Federal Bureau of Investigation or other organizations, for any criminal history in accordance with applicable statutes.

6. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.

7. I understand that there will be a 90-day orientation period of employment if I am hired by Jasper Plumbing Services, LLC I acknowledge that completion of an orientation period or conferral of regular status does not change my status as an employee-at-will or in any way restrict the Company's right to terminate me or change the terms or conditions of employment.

8. I, the undersigned, do hereby authorize any investigator or duly accredited representative of Jasper Plumbing Services, LLC bearing this release to obtain any information from school, residential management agents, employers, criminal justice agencies, or individuals relating to my activities. This information may include, but is not limited to, academic, residential achievement, performance, attendance, personal history, disciplinary and conviction records.

9. I hereby ask you to release such information upon request of the bearer. I understand that the information released is for official use by Jasper Plumbing Services, LLC and may be disclosed to such third parties as necessary in the fulfillment of official responsibilities. I hereby release and hold harmless any individual, including record custodians, from any and all liability for damages of whatever kind or nature which may at any time result to me on account of compliance, or any attempts to comply, with this authorization.

By agreeing to these terms and conditions, I certify that I have read, understood, and agreed to the conditions outlined in this applicant’s statement and that every piece of information I have provided on this application is true and correct to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably.

I agree to the terms and conditions.

Job Application Form

EDUCATION

Schools, Colleges, & Universities

MILITARY SERVICE

Please list all continuing education certificates you currently hold:

Employment History

Position #1

Position #2

Position #3

Resume