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It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, age, marital or veteran status, the presence of a non-job- related medical condition or handicap, or any other legally protected classification.

Date of Application:

Position(s) applied for:

Referral Source:

Friend

Employment Agency

Other

EMPLOYMENT EXPERIENCE

Are you employed now?(Required)

Yes

May we contact your present employer?(Required)

Yes

Please provide the following requested information regarding your employment history for up to the last ten years: Include military service assignments and volunteer activities. You may exclude organization names that indicate race, color, religion, gender, national origin, ancestry, age, disability or other protected status.

Most Recent Employer

Most Recent Employer(Required)

Name and Title of Supervisor(Required)

Address(Required)

Starting Position (Describe duties)(Required)

Start Date(Required)

End Date(Required)

Phone(Required)

Reason for Leaving(Required)

Position on Leaving (Describe Duties)(Required)

Previous Employer 1

Name and Title of Supervisor

Address

Start Date

End Date

Starting Position (Describe duties)

Phone

Reason for Leaving

Position on Leaving (Describe Duties)

Previous Employer 2

Name and Title of Supervisor

Address

Start Date

End Date

Starting Position (Describe duties)

Phone

Reason for Leaving

Position on Leaving (Describe Duties)

Previous Employer 3

Name and Title of Supervisor

Address

Starting Position (Describe duties)

Start Date

End Date

Phone

Reason for Leaving

Position on Leaving (Describe Duties)

Have you ever been discharged by an employer?(Required)

Yes

Please explain all terminations:

List all periods during which you were unemployed:

How did you spend this time?

List professional, trade, business, or civic activities and offices held. (You may exclude memberships that would reveal race, color, religion, gender, age, ancestry, national origin, disability or other protected status):

References One

Reference One(Required)

Business(Required)

Phone(Required)

Years Acquainted(Required)

References Two

Reference Two

Business

Phone

Years Acquainted

Reference Three

Business

Phone

Years Acquainted

Please tell us in one or two paragraph why you should be selected…

Consent

I hereby acknowledge that I have read and understand the statements below

APPLICANT’S STATEMENT
I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would affect this application unfavorably. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize Ravinia Plumbing and Heating Co., Inc. to make an investigation of any of the facts set forth in this application. I agree to immediately notify Ravinia Plumbing and Heating Co., Inc. if I should be convicted of a felony, or any crime involving dishonesty, breach of trust, controlled substances, sexual misconduct, abuse, or violence, while my job application is pending, or during my period of employment, if hired.
I authorize my previous employers, schools or persons named as references to give any information regarding employment or educational record. I agree that this company and my previous employers shall not be held liable in any respect if a job offer is not extended, is withdrawn or my employment is terminated because of false statements, omissions or answers made by me on this application. I understand that, if hired, I am obliged to comply with any and all current and subsequently adopted company polices.
In compliance with the Immigration Reform and Control Act of 1986, I understand that I will be required to provide approved documentation that verifies my right to work in the United States on my first day of employment.
I understand that this application does not create a contract of employment. I understand that, if hired, employment at Ravinia Plumbing, Heating & Electric Co., Inc. (RPHE) is “at will,” which means that either I or RPHE can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager or executive of RPHE other than the President, has any authority to alter the foregoing.
I hereby acknowledge that I have read and understand the above statements.

Education

High School

College/University

College/University

Training or Education

EMPLOYMENT EXPERIENCE

Most Recent Employer

Previous Employer 1

Previous Employer 2

Previous Employer 3

References One

References Two

Reference Three

Consent

Service Areas

Ravinia Plumbing

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