Southeast Restoration Group
Application For Employment

Applications are received and employees are hired without regard to race, creed, religion, color, sex, age, national origin, marital status, citizenship, or physical or mental disability.  In addition, we encourage the employment of veterans.  The receipt of this application does not mean that job openings exist and does not obligate us in any way.  We appreciate your interest in our organization.

AN AAP/ EQUAL OPPORTUNITY EMPLOYER -- DRUG FREE WORKPLACE

PERSONAL INFORMATION

Date:

Name:                    Social Security # XXX-XX-      Date of Birth
            Last                                First                              Middle initial

Present Address:                    
                              No.                   Street Name                                  Building No.         City                                          State            Zip Code
Previous Address:                    
                              No.                   Street Name                                  Building No.         City                                          State            Zip Code
Telephone:              Cell Phone:              Email Address: 
Valid Driver's License #          Expiration Date:         State:
Do you own a reliable vehicle? Yes    No 
Do you currently use tobacco products? Yes    No

Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of offense, seriousness and nature of violation, rehabilitation and position applied for will be taken into account.

Are you currently on probation? Yes    No 
Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?  Yes    No    
if yes, please provide city, state, date(s) and details below.

EMPLOYMENT INFORMATION EDUCATION INFORMATION
Position applying for
Expected salary
Date available for work
Employment type: Full-time Part-time Temporary
If part-time, what days?    hours?
Are you employed now? Yes    No
May we contact your employer? Yes    No
Have you ever served in the Military Service Yes    No
Number of years in service
Rank
Branch
Did you graduate H.S.? Yes No
If no, highest grade completed
Name of High School attended:

  Name Degree Graduate?
Trade\
Business
School
Yes No
Yes No
Yes No
       
College\
University
Yes No
Yes No
Yes No
       

PAST EMPLOYMENT SECTION

LIST BELOW PRESENT AND PAST EMPLOYMENT BEGINNING WITH YOUR MOST RECENT

1. From: (Mo/Yr)  
To:      (Mo/Yr) 
Position Held:    
Name and address of company:
Supervisor:
Telephone:  
Start rate:
Last rate:  
Reason for leaving:
2. From: (Mo/Yr)  
To:      (Mo/Yr) 
Position Held:    
Name and address of company:
Supervisor:
Telephone:  
Start rate:
Last rate:  
Reason for leaving:
3. From: (Mo/Yr)  
To:      (Mo/Yr) 
Position Held:    
Name and address of company:
Supervisor:
Telephone:  
Start rate:
Last rate:  
Reason for leaving:

How many employers have you had in the past ten(10) years?
May we contact the Employers listed above? Yes    No
If not, indicate by number which ones you do not wish us to contact:


Please check all areas for which you have experience:
Yes    No    Stucco Repair Yes    No    Cementicious Coatings
Yes    No    Caulking (2-part material) Yes    No    Carbon Fiber Installations
Yes    No    Painting (Commercial) Yes    No    Tuck Pointing
Yes    No    Elastomeric Wall Coatings Yes    No    Working on Swing Stages
Yes    No    Urethane Deck Coatings Yes    No    High Reach Equipment
Yes    No    Below Grade Sheet Membrane Yes    No    Hopper Gun  
Yes    No    Below Grade Liquid Membrane Yes    No    Compressors 
Yes    No    Metallic Iron Yes    No    Sand Blast Equipment
Yes    No    Bentonite Panels Yes    No    Spray Equipment
Yes    No    Expansion Joint Restoration Yes    No    Roof Repairs
Yes    No    Concrete Repairs Yes    No    Concrete Finishing 
Yes    No    Epoxy Injection Yes    No    Concrete Patch Repair
Yes    No    Form Work (Carpenter Skills) Yes    No    Single Ply Roofing
Would you be able to perform the above duties on a daily basis if needed? Yes    No
Have you ever been responsible for or overseen a job in which you supervised other men? Yes    No
How many men have you supervised?
Briefly describe your past job experiences and responsibilities:
Briefly describe any special skills you may have, including equipment certifications:

I certify that this application is true to the best of my knowledge and that falsified information will be grounds for termination.  I authorize investigation of all statements and references listed above.  I understand that, if hired, my employment is for no definite period and may be terminated at any time without prior notifications.  (sign & date below)


APPLICANT SIGNATURE:       DATE:
(sign by entering your full name)