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 APPLICATION FOR EMPLOYMENT                DATE:

Name (Last Name First):

 Social Security Number:
Present Address:
 City:
 State:
 Zip Code:

Permanent Address:

 City:
  State:
 Zip Code:
Phone Number with Area Code:
 Referred By:

 EMPLOYMENT DESIRED
Position:
 Date You Can Start:
 Salary Desired:
Are You Employed? YES NO If So, May We Inquire Of Your Present Employer? YES NO
     

 EDUCATION HISTORY
NAME & LOCATION OF SCHOOL
YEARS ATTENDED
DID YOU GRADUATE?
SUBJECTS STUDIED
Grammer School
High School
College
Trade, Business or Correspondence School

 GENERAL INFORMATION
Subjects or Special Study/Research Work or Special Training Skills:
U.S. Military or Naval Service:
 Rank

 FORMER EMPLOYERS (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)
DATE, MONTH AND YEAR
NAME & ADDRESS OF EMPLOYER
SALARY
POSITION
REASON FOR LEAVING
From:
To:
From:
To:
From:
To:
From:
To:
 
 REFERENCES
NAME ADDRESS BUSINESS YEARS KNOWN


SUPPLIMENTAL APPLICATION

Do you have a truck/van? Yes    No
Do you have air?   Yes    No
Do you have tools? Yes    No
Are you well tooled?   Yes    No
PLEASE LET US KNOW YOUR AMOUNT OF EXPERIENCE.
Experience Legend (please choose from the drop-down list): 1=Little to None;
2=Little to Some; 3=Some to Average; 4=Average to Experienced; 5=Experienced to Expert
Foundation:
Framing:
Finish:
Roofing:
Siding:
WIndows:
Plumbing:
Electrical:
Sheetrock:
Mud/Tape/Texture:
Tile:
P-Lam Counter Tops:
Other Experience:

 

AUTHORIAZATION

By clicking the SUBMIT button you certify that the facts contained in this application are true and complete to the best of your knowledge and you understand that, if employed, falsified statements on this application shall be grounds for dismissal. You authorize investigation of all statements contained herein and the references and employers listed above to give Tom Miller Construction any and all information concerning your previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utililization of such information.

You also understand and agree thatt no representative of the company has any authority to wnte into any agreement for employment for any specified period fo time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. 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 other relevant federal and state laws.

Tom Miller Construction
16000 Bothell Everett Hwy #130
Mill creek, WA 98012
 
Licensed - Bonded - Insured
TOMMIC*930DK 		Office: 425-941-4414
 
Email: tmiller@millerconstruction.net