Instructions: Fill out this form, then print it out and fax it in to 973-696-9395.

Call 973-696-9393 for an interview.

Application for Employment

This application form helps the company to evaluate your suitability for employment. It is not an employment contract. Please answer each question completely and to the best of your ability. False or misleading statements and/or material omissions are grounds for refusal, or termination, of employment and benefits. Federal law provides penalties for false statements or documents related to U.S. employment eligibility.

We consider all applicants for employment without discrimination because of gender, marital status, race, age, creed, or national origin, or other legally protected status. Additional testing of job related skills necessary to accomplish the responsibilities for the position for which you are applying may be required prior to your employment.

Section 1 – Personal Information

Name (last, first, middle)

Address                   No. years there

City, State, Zip 

Previous address    No. years there

City, State, Zip 

E-Mail Address                                                                                                            

Home Phone    Work   OK to call work? yes  no                                                                                                                                       

Social Security Number

Please provide any special information we may need about your name, or use of another name, for us to be able to check your work record and otherwise verify the information given in this Application.

Are you employed?            Y            N            On what date would you be available for work?

Goals (What would you like to be doing in 2 years?)

In case of an emergency, we should notify: Name Phone  

Section 2 – Employment Interest

Position desired               

If hired, can you provide the documents required to prove that you are legally able to work in the U.S.? 

Y N

Can you perform the essential job functions for the position for which you are applying?    Y N          

Can you work 8 am – 6 pm, Monday through Friday?                                                                 Y N

Can you work after 6 pm?                                                                                                              Y N

Can you work Weekends?                                                                                                              Y N

List special skills, training, experience which might help you while working for Mr. Handyman :

What is the most important to you?  Place a 1 by the most important, 2 by the next, and so forth.

Health Benefits

Free weekends and evenings

Income

Paid vacation

Advancement

Section 3 – Background Information

Have you ever been convicted of a felony offense?                   Y N 

Have you ever been convicted of a misdemeanor offense?       Y N 

Have you ever been convicted of a driving offense?                  Y N            When:   

Drivers License #       State Expiration

    Restrictions        

Have you ever threatened or committed an act of violence, harassment or discrimination against a fellow employee, customer, or any other person?        Y N                         

If you answered yes to any of the above, please explain.

Section 4 – Education

Name/location of the school most recently attended

Last grade completed Are you currently attending school?        Y N 

If yes, night classes    day classes         Where are the classes?

Are there any classes or work experiences that might help you at Mr. Handyman ?

Section 5 – Personal References

List two people who know you and who are not relatives.

Name         How long have they known you?

        How do you know them?

        Address    

        Telephone

Name          How long have they known you?

        How do you know them?

            Address

         Telephone

Section 6 – Employment Record

Have you been discharged or asked to resign by any previous employer?            Y N  

If yes, please describe why                                                                                                                                      

Please list information about your last few jobs:

Employer’s Name w/ Complete Address      Type of Business

Job Title              to Employed From

Duties                 Immediate Supervisor

Telephone          Reason for Leaving

Employer’s Name w/ Complete Address      Type of Business

Job Title              to Employed From

Duties                 Immediate Supervisor

Telephone          Reason for Leaving

Employer’s Name w/ Complete Address      Type of Business

Job Title              to Employed From

Duties                 Immediate Supervisor

Telephone          Reason for Leaving

May we contact the employers listed above?       Y N                          

If not, please indicate which one(s) you do not wish us to contact:
 

Section 7 – Authorization and Understanding Certification

                        (Please check in the box to the left of each statement indicating that you agree with the statement)

   I certify to the best of my knowledge and belief. I understand that any false information, material omissions or misrepresentations of facts requested in this application may result in rejection of my application or termination at any time during my employment.

   I certify that I am not a current user of illegal drugs.

   I understand and acknowledge that, as a condition of my being offered employment and continued employment, I will submit upon request to such lawful examinations as may exist to test for the illegal use of drugs.

   I understand that I may not work under the influence of alcohol, drugs, chemicals, or other controlled substances. I also understand that I may be required to submit to examinations that test for such substances if I am involved in a work-related accident.

   I agree to sign, as a requirement of employment, a Release and Authorization Agreement and other documents necessary to obtain consumer credit reports. I understand that these documents authorize the company and/or any of its agents, at any time before and during my employment, to conduct reference checks, driving and criminal history checks and other consumer report investigation(s) considered necessary.

   I understand that all offers of employment require satisfactory proof of my identity and legal authority to work in the United States. I also understand that an offer of employment is conditioned upon the company’s receipt of satisfactory responses to reference requests and background checks.

   If I am offered employment, I understand that I will be asked to complete a medical history questionnaire and/or other medical examination.

   I understand and agree that if offered employment by the company, and I accept the offer, I will become an “at-will” employee of the company. As an “at will” employee, I will have the right to terminate my employment at any time for any reason, or for no reason, with or without advance notice. I further understand and agree that the company has the same right to terminate my employment, with or without cause and with or without advance notice. I also understand that, if employed, my “at-will” employment status does not change unless the company president/owner, and I, sign a written document that changes my employment status.

   I understand and agree that employee handbooks, manuals, personnel policies, and procedures are not employment contracts and do not change my status as an “at-will” employee.

PLEASE READ

This application will only be considered for the ninety-day period after its receipt by Mr. Handyman . Should you wish to be considered after the expiration of this period, you must reapply.