Employment Application

1st Call Restoration, LLC provides equal employment opportunity to all qualified persons, and does not unlawfully discriminate against any person on the basis of race, color, creed, religion, sex, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

Please -

• Complete all items on the application, even if the information is included on your resume or other document submitted by you.
• Sign and date your application.
• Specify the exact title of the position in which you are interested.

Position Applying For:

Personal Information

Name (Last, First, Middle)

Address (Street)

Address (City, State, Zip Code)

Telephone Number

Email

Date of Birth (mm/dd/yy)

General Information

Are you legally eligible for work in the U.S.A.? (If yes, verification will be required)
YesNo

Do you have a valid Texas Driver's License with NO moving violations?
YesNo
(If no, please explain)

As part of our hiring process a thorough background, credit and drug test may be completed. Are there any current or prior issues that may be present during this process?
YesNo
(If yes, please explain)

Have you ever received workers compensation, disability or other benefits for a work related injury?
YesNo
(If yes, please explain)

Are you able to complete physical labor including: bending, squatting and standing for long periods of time and lifting more than 50 lbs?
YesNo
(If no, please explain)

Have you ever been convicted of a misdemeanor with in the past 3 years or felony (anytime)?
YesNo
(If yes, please explain)

Employment Request

Minimum Wage Requested:

Minimum Hours Requested:

If applicable, are you available for overtime?YesNo

If applicable, are you available for travel?YesNo

Earliest Date you can begin work?

How did you hear about this position?

RecruiterInternet Job PostingNewspaper ClassifiedCompany WebsiteOther

If Other:

Employment History

*Please begin with most recent employment

May we contact your current employer?YesNoNot Applicable

Employer:

Address:

Supervisor:

Telephone

Start Date:

End Date:

Position Title:

Position Duties:

Reason for Leaving:

Employer 2 (if applicable)

Employer:

Address:

Supervisor:

Telephone

Start Date:

End Date:

Position Title:

Position Duties:

Reason for Leaving:

Employer 3 (if applicable)

Employer:

Address:

Supervisor:

Telephone

Start Date:

End Date:

Position Title:

Position Duties:

Reason for Leaving:

Education

High School/GEDCollege/UniversityGraduate SchoolVocational/Specialized

Name

Location

Course of Study

Degree Obtained

High School/GEDCollege/UniversityGraduate SchoolVocational/Specialized

Name

Location

Course of Study

Degree Obtained

High School/GEDCollege/UniversityGraduate SchoolVocational/Specialized

Name

Location

Course of Study

Degree Obtained

Military

Military Service: YesNo

Branch

Specialized Training

Recomendations

Name

Company

Title

Contact Information

Name

Company

Title

Contact Information

Name

Company

Title

Contact Information

Signature

I certify that the facts set forth in this application are true, complete, and correct to the best of my knowledge. I understand that any misrepresentations, falsifications, or omissions on this application can be grounds for rejection of my application or, if I am employed by this company, for my immediate termination from employment. I authorize 1st Call Restoration, LLC to make any necessary inquiries and investigations into my education, military, or employment history. I further authorize, unless otherwise indicated on this application, the release of my information to 1st Call Restoration, LLC by any of the schools, services, or employers listed on this application.

Signature

Today's Date