welcome
employment
Thank you for your interest in working at Five Star Plumbing and Drains, at this time we are not hiring but we are always taking application for a later date. Please fill out the below application and we will keep it on file and contact you in the future. Again thank you for your interest.
Applicant Information
Last Name First M.I. Date
Street Address Apartment/Unit #
City State ZIP
Phone E-mail Address
Date Available Social Security No. Desired Salary
Position Applied for
Are you a citizen of the
United States?
Yes
 
No
  		If no, are you authorized
to work in the U.S.?
Yes
No
Have you ever worked
for this company?
Yes
 
No
  		If so, when?
Have you ever been convicted of a felony?
Yes
 
No
  		If Yes, explain
Education
High School
Address
From
To
 Did you graduate?
Yes
No
Degree
College
Address
From
To
 Did you graduate?
Yes
NO
Degree
Other
Address
From
To
 Did you graduate?
Yes
NO
Degree
References
Please list three professional references.
Full Name
Relationship
Company
Phone
 ( )
Address
Full Name
Relationship
Company
Phone
 ( )
Address
Full Name
Relationship
Company
Phone
 ( )
Address
Previous Employment
Company
Phone
 (  )
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
 
NO
  		 
Company
Phone
 (  )
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
 
NO
  		 
Military Service
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature Date
 
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