Job Application - Handyathome

New Employee Application

Handy@Home®, prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or a part of an individual’s income is derived from any public assistance program.

Note: Please complete the application as thoroughly as possible. Try not to leave any part unfinished. Military service or higher education are not required fields in this application.

POSITION APPLYING FOR:

PERSONAL INFORMATION

First Name

Last Name

Current Address

City

State

Zipcode

Permanent Address (if different from above):

First Name

Last Name

Current Address

City

State

Zipcode

Telephone

Driver's License #:

State

I am a U.S. Citizen or otherwise authorized to work in the United States on an unrestricted basis:

YesNo

Have you ever been convicted of a crime in the past seven years (you are not obligated to disclose sealed or expunged criminal records)?

YesNo

If you answered yes, please explain:

Have you ever served in the U.S. Military?

YesNo

If yes, please provide the following information:

Branch of Service:

Rank at time of separation:

I served from

Special Honors:

EMPLOYMENT HISTORY:

Present or Most Recent Employer

Employer:

Address:

Your Position:

Salary:

Duties:

Dates of Employment:

Reasons for Leaving:

Prior Employer

Employer:

Address:

Your Position:

Salary:

Duties:

Dates of Employment:

Reasons for Leaving:

Prior Employer

Employer:

Address:

Your Position:

Salary:

Duties:

Dates of Employment:

Reasons for Leaving:

EDUCATION

High School

Name

Address

Did you graduate?

YesNo

Attended from

If you did not graduate, did you receive your GED?

YesNo

Special honors or awards:

Technical or Vocational School

Name

Address

Did you graduate?

YesNo

Attended from

Degree or Certification:

Specialty:

Special honors or awards:

College or University

Name

Address

Did you graduate?

YesNo

Attended from

Degree:

Major:

Special honors or awards:

College or University

Name

Address

Did you graduate?

YesNo

Attended from

Degree:

Major:

Special honors or awards:

POSITION INFORMATION:

Position Specifications

Position Applying For:

How did you hear about this job?

What hours are you willing to work?

Would you be able to work weekends?

YesNo

Are you willing to travel for the job?

YesNo

When would you be able to start?

Desired salary:

per

Skills

Please describe any skills you have in the following areas:

Trade Skills What Can You Do At a Professional Quality Level:

Languages Spoken (other than English):

Other:

I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate any aspect of my prior educational and employment history.

Furthermore I understand that if I am hired, employment with this company is "at will," which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.