Application for Employment

Please provide complete information. An incomplete application may affect your consideration for employment. If you
need assistance in completing the application, please let us know so that we can discuss a reasonable accommodation.

Builders, Inc. is an equal opportunity employer committed to a policy of nondiscrimination with respect to race, color, religion, sex, national origin, and any other class protected by federal, state, or local law, including, but not limited to, medical condition, disability, marital status, age, sexual orientation or pregnancy.

In the processing of this application, we may perform routine inquiries that will provide information concerning your personal history and past work experience. Proof of age, military service, and education may be required upon hiring.

General Information

First Name *

Middle Name *

Last Name *

Address *

City *

State *

Zip Code *

Home Phone Number

Cell Phone Number *

Email Address *

Date Available for Work

Have you ever worked for Builders, Inc. before? *

Yes

No

Are you authorized to work in the United States? *

Yes

No

Are you 18 or older? *

Yes

No

Are you able to meet the attendance requirements for the position? *

Yes

No

Will you work overtime if required? *

Yes

No

Position Information

Type of Work Desired *

Salary Expected *

Applying for *

Full-time

Part-time

Seasonal

(Inability to work certain days/hours will not necessarily disqualify you from employment.)

If employee or other please list:

Education

High School

City/State

Years Completed

Graduated

Yes

No

Course of Study

College

City/State

Years Completed

Graduated

Yes

No

Course of Study

Vocational or Trade School

City/State

Years Completed

Graduated

Yes

No

Course of Study

Other

City/State

Years Completed

Graduated

Yes

No

Course of Study

Do you plan to continue your education? *

Yes

No

If yes, what area?

Credentials and Special Skills

Describe your practical experience and/or training.

Skills/Abilities

List your professional or technical licenses:

Background Information

During the past five years, have you had any periods of unemployment? *

Yes

No

If yes, when?

May we contact your current employer? *

Yes

No

If not, specify a reason:

During the past five years, have you ever been discharged, suspended or asked to resign for any reason from any position? *

Yes

No

If yes, specify a reason:

For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the organizations you have listed? *

Yes

No

If yes, please explain:

Within the past seven years, have you been convicted of a crime other than misdemeanor traffic violations? *

Yes

No

If yes, specify:

Having a criminal record, other than misdemeanor traffic violations, does not necessarily mean you will be denied employment.

Employment Record

List all employment for the past five years, starting with the most recent or present employer. RESUMES CANNOT be substituted for completing this employment record.

Employer *

Nature of Employment *

Length of Employment

From *

To *

Address *

Phone Number *

Your Title *

Supervisor *

Supervisor's Title *

Principle Responsibilities – Be Specific *

May we contact them for a reference? *

Yes

No

Later

Employer

Nature of Employment

Length of Employment

From

To

Address

Phone Number

Your Title

Supervisor

Supervisor's Title

Principle Responsibilities – Be Specific

May we contact them for a reference?

Yes

No

Later

References

List the names and phone numbers of three business/work references who are not related to you and are not previous supervisors. If none available, list school or personal references not related to you.

Name *

Telephone *

Years Known *

Name *

Telephone *

Years Known *

Name *

Telephone *

Years Known *

Please Read Carefully Before Submitting

Applicant Signature (type full name) *

Date *