Date of application:
Date you are able to start:
Position applied for:
Salary desired:
Full name:
Current address (Include Street, City , State, Zip:)
Previous address, if applicable (Include Street, City , State, Zip:)
Telephone number where you can be reached:
Are you authorized to work in the United States Of America:
Yes
No
GENERAL INFORMATION
Have you ever been employed with The Waterworks before:
Yes
No
If yes, when:
If yes, reason for leaving:
Have you ever applied with The Waterworks before:
Yes
No
If you have applied, when:
How did you learn about The Waterworks:
Are you employed now:
Yes
No
If yes, may we contact your present employer?
Yes
No
Current employer's contact person:
Current employer's phone number:
If we cannot inquire of your present employer, please explain why:
Who referred you to The Waterworks?
Are you on layoff and subject to recall?
Yes
No
If employed, does your employment require you to continue working, or restrict your activities after leaving your current employment, for any period of time?
Yes
No
If yes, until what date?
Are you 18 years old or older?
Yes
No
Do you have any work schedule restrictions with regard to overtime, weekends, serving on-call? Please explain:
In case of emergency, name of person to contact:
In case of emergency, phone number of person to contact:
Are you physically and mentally capable of performing the essential duties of the position for which you are applying?
Yes
No
If no, please explain:
Are you a veteran of the U.S. Uniformed Service(s)
Yes
No
If yes, what branch(es)?
have you ever been convicted of a crime, other than a minor traffic violation?
Yes
No
If yes, please explain:
NOTE : A conviction record will not necessarily be a bar to your employment.
EMPLOYMENT HISTORY
(List below your last five employers, beginning with your current or most recent employer.)
1. Date-Month/Year:
1. Company Name & Address, Phone Number, Contact Name:
1. Wage/Salary and Position Held:
1. Reason for leaving:
2. Date-Month/Year:
2. Company Name & Address, Phone Number, Contact Name:
2. Wage/Salary and Position Held:
2. Reason for leaving:
3. Date-Month/Year:
3. Company Name & Address, Phone Number, Contact Name:
3. Wage/Salary and Position Held:
3. Reason for leaving:
4. Date-Month/Year:
4. Company Name & Address, Phone Number, Contact Name:
4. Wage/Salary and Position Held:
4. Reason for leaving:
5. Date-Month/Year:
5. Company Name & Address, Phone Number, Contact Name:
5. Wage/Salary and Position Held:
5. Reason for leaving:
Comments, please include explanation of gaps in employment:
EDUCATION HISTORY
High School:
Subject Studied (High School):
Number of years attending (High School):
Did you graduate (High School):
Yes
No
Trade/Technical School:
Subject Studied (Trade/Tech School):
Number of years attended (Trade/Tech School):
Did you graduate (Trade/Tech School):
Yes
No
College:
Subject Studied (College):
Number of years attended (College):
Did you graduate (College):
Yes
No
List special skills or training you possess which may be applicable to the position you are applying for:
REFERENCES
Give the names of three people, not related to you, whom you have known for at least one year.
1. Name:
1. Address & Phone Number:
1. Occupation & Number of Years Acquainted:
2. Name:
2. Address & Phone Number:
2. Occupation & Number of Years Acquainted:
3. Name:
3. Address & Phone Number:
3. Occupation & Number of Years Acquainted:
Please read the The Waterworks Applicant Certification and The Waterworks Disclosure and check the box below.
I have read and agree to The Waterworks Applicant Certification and The Waterworks Disclosure. By checking this box I understand that this constitutes an electronic signature and that this box must be checked before this application can be processed.
This application will be kept on file for 90 days.
