Maintenance Team Employment Application

Current Date(Required)

Personal Information

Please input all information carefully.

Name(Required)

First Last

DOB(Required)

SSN(Required)

Driver's License Number(Required)

Current Address(Required)

City/State/Zip(Required)

Do you:(Required)

Own a home

Rent an apartment/home

Live with a relative

Are you legally authorized to work in the US?(Required)

Yes

Are you under the age of 18?(Required)

Yes

What type of job are you applying for?(Required)

Full time

Part time

Have you ever been convicted of a crime?(Required)

Yes

Date(s) and Charge(s)(Required)

What position are you applying for?(Required)

Hourly Wage Expected

Are you in the military or military reserves?(Required)

Yes

Do you own a car?(Required)

Yes

Do you have auto insurance?(Required)

Yes

Do you consent to drug tests?(Required)

Yes

Employment Information

Please account for the last 5 years, starting with the most recent. Complete even if you are attaching a resume.

How would you categorize your current work?(Required)

Working with a company

Withing with/as a contractor

Self-employed

Unemployed

Company Name

Dates/Term of Employment

Company Phone

Address

Ending Salary

Title

Supervisor's Name

Reason for Leaving

What kind of work did you do?

Company Name

Dates/Term of Employment

Company Phone

Address

Ending Salary

Title

Supervisor's Name

Reason for Leaving

What kind of work did you do?

Company Name

Dates/Term of Employment

Company Phone

Address

Ending Salary

Title

Supervisor's Name

Reason for Leaving

What kind of work did you do?

Education

High School Name, City and State

Highest Grade Completed

Are you still attending?

College/Technical or Trade School/or other Education/Training (list all whether or not degree was obtained)

Please include the school name(s), location(s), dates of enrollment, major/minor (if applicable), and degree completed (if applicable).

What foreign languages do you speak fluently?

Describe any abilities, experience, or aptitude that you believe would be helpful in your job.

References

Please provide the names of two people (not related to you) whom you have know for at lease a year.

Name

Phone

Company

Years Acquainted/Relation

Name

Phone

Company

Years Acquainted/Relation

Emergency Contact Information

Name(Required)

Phone(Required)

Address(Required)

City/State/Zip(Required)

Your Availability

Weekly Availability(Required)

Please include the earliest and latest time you are available on each day of the week, including Saturday and Sunday.

Equal Opportunity Information

We are an equal opportunity employer and do not discriminate based upon race, color, religion, sex, sexual orientation, medical condition, or any other consideration made unlawful by applicable federal, state, or local law. You are not obligated to complete this section of the application, but your assistance would be appreciated.

Gender

Ethnicity

Physical Demands

Physical demands may include: (A) standing and walking for extended periods of time, (B) occasional lifting weights of up to 75lbs, (C) frequent lifting weights of up to 25lbs, and (D) shoveling of snow.

Final Acknowledgement

I authorize Harrison Richards and HR Holdings to make any necessary investigations into my personal history and authorize any former employer, educational institution, law enforcement agency, government agency, financial institution, or other person having personal knowledge about me to supply Harrison Richards and HR Holdings or its agents with any information concerning my background. I release from liability and hold harmless any individual or agency supplying this information to Harrison Richards and HR Holdings or its agents. I have received a Notice of Disclosure Under the Fair Credit Reporting Act. I answered every question on this application completely, truthfully, and correctly. I understand that if I am hired and any of the information I provided is found to be untruthful, misstated, or purposely omitted, I could lose my job. I understand that this application is not an offer, promise, or contract of employment, either expressed or implied. My employment would be “at will” and could be terminated by either Harrison Richards, HR Holdings or me at any time, with or without notice or cause. This application will be considered for 14 days. For consideration after that, I must submit a new application. I agree not to bring tobacco, alcohol, or nonprescription drugs to work. Smoking and vaping are not permitted on the premises.

Applicant's Signature(Required)

File Uploads

Drop files here or

Max. file size: 100 MB.

Please upload any files/documents (such as a resume/CV) that you wish to include with your application.

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