New Technology Plumbing
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Employment Application
We consider all applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.
*Required Fields
*
Position(s) Applied For:
*
Date of Application:
/
/
(MM/DD/YYYY)
How Did You Learn About Us:
Select One
Advertisement
Employment Agency
Friend
Relative
Inquiry
Other
If Other, Please Specify:
*
First Name:
Middle Name:
*
Last Name:
*
Address:
Address (Line 2)
*
City:
*
State:
*
Zip:
*
Email:
*
Telephone Number:
Best Time to Contact You:
Please Select
Anytime
Weekdays After Work (5:30pm)
Evenings (7:00pm)
Weekends
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Please Select
Yes
No
I am over 18
Have you ever filed an application with us before?
Please Select
Yes
No
If yes, please give date:
/
/
(MM/DD/YYYY)
Have you ever been employed with us before?
Please Select
Yes
No
If yes, please give date:
/
/
(MM/DD/YYYY)
Do any of your friends or relatives, other than a spouse, work here?
Please Select
Yes
No
If yes, please specify:
Name:
Relationship:
Location:
Are you currently employed?
Please Select
Yes
No
May we contact your present employer?
Please Select
Yes
No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?
(Proof of citizenship or immigration status will be required upon employment)
Please Select
Yes
No
Date Available for work:
/
/
(MM/DD/YYYY)
Desired Salary:
What hours are you available for work?:
Full-Time:
Full-Time (Please Specify)
Shift 1
Shift 2
Shift 3
Part-Time:
Part-Time (Please Indicate)
Mornings
Afternoons
Evenings
Temporary (indicate dates):
FROM:
/
/
TO:
/
/
Are you currently on "lay-off" status and subject to recall?
Please Select
Yes
No
Can you travel if the job requires it?
Please Select
Yes
No
Work Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.
Employer:
Work Performed
Address:
Phone Number:
Job Title:
Supervisor:
Reason For Leaving:
Dates Employed
From:
/
/
To:
/
/
Hourly Rate / Salary
May we contact?
Yes
No
Starting:
Final:
Employer:
Work Performed
Address:
Phone Number:
Job Title:
Supervisor:
Reason For Leaving:
Dates Employed
From:
/
/
To:
/
/
Hourly Rate / Salary
May we contact?
Yes
No
Starting:
Final:
Employer:
Work Performed
Address:
Phone Number:
Job Title:
Supervisor:
Reason For Leaving:
Dates Employed
From:
/
/
To:
/
/
Hourly Rate / Salary
May we contact?
Yes
No
Starting:
Final:
New Technology Plumbing
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1401 N. Kraemer Blvd. "B", Anaheim, CA 92806 • Tel: (714) 688-0800 • Fax: (714) 688-0803
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