Plumbing Mart of Florida

Professional Plumbing Service

Employment

Application for Employment

Personal Information:

*Last Name:	*First Name:	MI:
Address:
City:	State:	Zip:
*Phone Number:	Business Number:	*Email Address:
Pay Expected:	When Will You Be Able to Start?:
Will You Work Overtime if Asked?: Yes No
Have You Ever Applied for Employment with Plumbing Mart?: Yes No If Yes, Month and Year:
Position Desired:
Apart from Absence for Religious Observance, Are You Available for Full-Time Work?: Yes No If Not, What Hours Can You Work:
Are You Legally Eligible for Employment in The United States?: Yes No
Other Special Training or Skills (Languages, Machine Operation, Etc.):

Education:

	Name & Location of School	Did you Graduate?	Degree
College:		Yes No
Business/Trade:		Yes No
High School:		Yes No

Membership in Professional or Civic Organizations:

Employment History 1:

*Start with current Employment*
Company Name:	Telephone:
Address:	Date of Employment:	End of Employment:
Name of Supervisor:	Weekly Pay-start:	Weekly Pay-end:
Job Title & Work Description:
Reason for Leaving:

Employment History 2:

Company Name:	Telephone:
Address:	Date of Employment:	End of Employment:
Name of Supervisor:	Weekly Pay-start:	Weekly Pay-end:
Job Title & Work Description:
Reason for Leaving:

Employment History 3:

Company Name:	Telephone:
Address:	Date of Employment:	End of Employment:
Name of Supervisor:	Weekly Pay-start:	Weekly Pay-end:
Job Title & Work Description:
Reason for Leaving:

Employment History 4:

Company Name:	Telephone:
Address:	Date of Employment:	End of Employment:
Name of Supervisor:	Weekly Pay-start:	Weekly Pay-end:
Job Title & Work Description:
Reason for Leaving:

Contacting Employers

We May Contact the Employers Listed Above Unless You Indicate Those You Do Not Want Us to Contact
Yes
No

Military:

Did you serve in the U.S. Armed Forces? Yes No	Branch:
Describe any training received relevant to the position for which you are applying

By sending this information, you agree to the following:
The information provided in this application is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer-reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request the name of the agency so I may obtain from them the nature and substance of the information contained in the report.

Plumbing Mart Of Florida
1744 Avenida Del Sol
Boca Raton, FL 33432
Boca Phone: (561) 392-2410
Boynton Beach Phone: (561) 737-5159
Broward Phone: (954) 971-2190
E-mail us: info@plumbingmartinc.com

Licensed in AL, FL, GA, NC, SC, VA, MD - FL Lic# CF CO57511 - Fully Insured

Plumbing Mart of Florida, 1744 Avenida Del Sol, Boca Raton FL, 33432 - (561) 392-2410 - info@plumbingmartinc.com
Treasure Coast - (772) 335-2621 | Palm Beach County - (561) 392-2410 | Broward and Dade Counties - (954) 563-8112