VERSADRAIN EMPLOYMENT APPLICATION FORM
 
Last Name: First Name: Middle:
Present Address: City:
State: Zip:
How long:
Social Security:
Primary Phone: Other Phone:
Email:
If under 18, please list age:
Position applying for:
Salary desired:
Days / Hour Availability  
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Availability  
How many hours can you work weekly:
Can you work weekends:
Employment desired:
When available for Work?
Education
Type of School Name of School Location Years Completed Major / Degree
High School
College
Bus. or Trade School
Professional School
       
Have you ever been convicted of a crime:
If applying for a driving position
What is your means of transportation:
Do you have a drivers license:
Drivers License Number: State of Issue:
Drivers License Expiration Date::
Type of Drivers License:
Have you had any accidents during the last 3 years: If yes, how many:
Have you had any moving violations during the last 3 years: If yes, how many:
Do you have a drivers license:
References
Name: Company:
Position: Address:
Phone Number:
Name: Company:
Position: Address:
Phone Number:
Work Experience
Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.
Name of Employer: Supervisor:
Address: Phone Number:
City, State, Zip: Position:
Start Date: End Date:
Starting Pay: Ending Pay:
Reason for leaving (be specific):
 
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer: Supervisor:
Address: Phone Number:
City, State, Zip: Position:
Start Date: End Date:
Starting Pay: Ending Pay:
Reason for leaving (be specific):
 
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer: Supervisor:
Address: Phone Number:
City, State, Zip: Position:
Start Date: End Date:
Starting Pay: Ending Pay:
Reason for leaving (be specific):
 
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer: Supervisor:
Address: Phone Number:
City, State, Zip: Position:
Start Date: End Date:
Starting Pay: Ending Pay:
Reason for leaving (be specific):
 
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
May we contact your present employer:
Please read carefully.
Application form waiver.

In exchange for the consideration of my job application by Versa Drain, Inc. (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of The Company , or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and The Company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.
I also understand that (1) the Company has a drug and alcohol policy that provides for pre employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.
I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.
I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.
Signature of applicant (Type Name): Date:
This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.
Thank you for completing this application form and for your interest in our business.

 

Continue to the brief 7 question plumbing test by pressing "Submit Application"