Employment Application

Applicant Information

First Name *

Middle Initial *

Last Name *

Address *

Address

Email *

Phone Number *

Employment

Position Applying For *

Date Available to Start *

Desired Salary* *

Are you 18 or over?* *

Yes

Are you legally authorized to work in the U.S.?* *

Yes

Have you ever worked for this company?* *

Yes

If yes, when?

Based on what you have been told or read, are you able to perform the essential functions and meet the minimum physical requirements of this job with or without accommodation? *

Yes

How did you find out job openings at Model Remodel?

Transportation

Do you have a valid Driver’s License? *

Yes

Have you had any accidents and/or moving violations in the past three years? *

Yes

If yes, how many?

Education

High School *

Address of High School *

Date From *

Date To *

Did you graduate? *

Yes

Degree

College

Address of College

Date From

Date To

Did you graduate?

Yes

Degree

Other Education

City, State of Other Education (ex: Seattle, WA)

Date From

Date To

Did you graduate?

Yes

Degree

Professional References

Please list three professional references.

Reference #1 *

Relationship *

Company *

Phone

Reference #2 *

Relationship *

Company *

Phone *

Reference #3 *

Relationship *

Company *

Phone

Previous Employment

Please list you’re most recent employer and all additional employers for the past 10 years. If you need additional information you may write in the extra text box at the bottom of this section.

May we contact your current employer? *

Yes

Does your present employer know you are considering leaving? *

Yes

Are there any previous employers who might not rehire you? *

Yes

If yes, please explain.

Company #1 *

Company Address #1 *

Supervisor Name *

Supervisor Phone *

Your Position at Company #1 *

Responsibilities at Company #1 *

Date From *

Date To *

Reason for Leaving *

Company #2

Company Address #2

Supervisor Name

Supervisor Phone

Your Position at Company #2

Responsibilities at Company #2

Date From

Date To

Reason for Leaving

Company #3

Company Address #3

Supervisor Name

Supervisor Phone

Your Position at Company #3

Responsibilities at Company #3

Date From

Date To

Reason for Leaving

Employment History Continued: Please use the area below to share any additional employment information you would like us to know, or include it on your attached resume at the bottom of this form.

Resume

Please upload your cover letter and resume below.

Upload File *

Maximum upload size: 52.43MB

CERTIFICATION AND ACKNOWLEDGEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to disqualify me from further consideration for employment with Model Remodel (MRM) (also known herein as “the Company”) and may be considered justification for immediate discharge from the Company whenever discovered. I understand that completion of this Application for Employment does not guarantee that I have been or will be employed by the Company. I authorize, the Company, its employees and representatives acting on its behalf to contact and obtain information from all references, employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I authorize persons, schools, current and previous employers and organizations to provide information that may be required to arrive at an employment related decision. I understand that these reference inquiries may include information as to my character, general reputation, personal characteristics and mode of living. I hereby hold harmless and release all parties from liability for any damages that may result from furnishing same information to the Company. I understand that the final offer of employment may be conditional upon the satisfactory completion of a criminal background check/urinalysis for drug testing purposes and/or a blood alcohol test. I hereby consent to either or both of said tests, at the Company’s discretion. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that in compliance with federal immigration laws I will complete an I-9 form. If I am hired, I understand that employment with the Company is “At-Will”. This means that my employment may be terminated at any time, with or without cause and without prior notice. I understand that no one at the Company has the authority to make an exception to this “at-will” rule, except in an individually written employment contract signed by the Owner. If I am hired, I agree to hold in strictest confidence any information concerning the Company, its Insureds, and its Agents which may come to my knowledge. This application does not constitute an agreement or contract for employment for any specific time.

Applicant Signature *

Clear

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

Date *