Employment ApplicationShane Ros2023-04-14T18:06:57+00:00 Fill out this form to apply for employment. Position Applying For(Required)Field Service TechnicianWarehouse/Stocking AssociateRetail AssociateInventory Manager Trainee /Customer Service SpecialistStore ManagerBookkeeperStocking/Warehouse PersonDate of Application(Required) MM slash DD slash YYYY First Name(Required)Middle Name(Required)Last Name(Required)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long have you lived at current address?(Required)How long at your previous address?(Required)Phone(Required)Alternate PhoneSocial Security Number(Required)Are you a US Citizen?(Required) Yes No Are you applying for full time or part time?(Required) Full Time Part Time Pay rate expected(Required)Date Available to Start(Required) MM slash DD slash YYYY What experience, skills, or qualifications do you have?(Required)What factory equipment can you operate?(Required)List any handicaps or health problems you may have that might affect work performance or should be taken into account in determining job placement?(Required)Can you work Monday-Friday 10-6 & Saturdays, May - July? If not, when are you available to work?(Required) Yes No If no, when are you available to work?(Required)Do you have a valid Driver's License?(Required) Yes No Do you have reliable transportation to work?(Required) Yes No Can you lift 75 pounds?(Required) Yes No Have you had a serious injury or illness in the past five years?(Required) Yes No If yes, please explain the illness or injury.(Required)Have you ever received compensation for injuries?(Required) Yes No If yes, please explain the compensation.(Required)Have you ever been convicted of a felony or do you have any felonies?(Required) Yes No If yes, please explain.(Required)Conviction records are not necessarily a bar to employment.US Military RecordBranch of ServiceType of dischargeLast Rank AttainedDuties performed during service.EducationHigh School Name & Location(Required)High School Course of Study(Required)High School Years Attended(Required)High School Diploma/Degree Received?(Required) Yes No College/University Name & LocationCollege/University Course of StudyCollege/University Years AttendedCollege/University Degree Received? Yes No Graduate Shcool Name & LocationGraduate School Course of StudyGraduate School Years AttendedGraduate School Degree Received? Yes No Vocational School Name & LocationVocational School Course of StudyVocational School Years AttendedVocational School Degree Received? Yes No Employment HistoryBegin with current or most recent employer. Do not exclude any employment. Include any applicable temporary employment. Enter any additional employment information in the box at the end of this section. Previous salaries or wages will not be used to determine compensation.Company Name(Required)Start Date(Required) MM slash DD slash YYYY End Date(Required) MM slash DD slash YYYY Salary(Required)Company Address(Required)Company Phone(Required)Name & Title of Supervisor(Required)Supervisor's PhonePosition Title(Required)Duties Performed(Required)What did you enjoy the least?(Required)What did you enjoy the most?(Required)Reason for leaving(Required)Company NameStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY SalaryCompany AddressCompany PhoneName & Title of SupervisorSupervisor's PhonePosition TitleDuties PerformedWhat did you enjoy the least?What did you enjoy the most?Reason for leavingCompany NameStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY SalaryCompany AddressCompany PhoneName & Title of SupervisorSupervisor's PhonePosition TitleDuties PerformedWhat did you enjoy the least?What did you enjoy the most?Reason for leavingPlease enter any additional employment details here.Previous Employer ReferencesName(Required)Address(Required)Phone(Required)Relationship(Required)Years Known(Required)Name(Required)Address(Required)Phone(Required)Relationship(Required)Years Known(Required)Emergency Contact InformationName(Required)Phone(Required)I understand that any omission or misrepresentation of material facts in this application may result in refusal of or separation from employment. I hereby authorize Blue Water Pool and Garden or Blue Water Construction subsidiaries to make any investigation of my background as deemed necessary. I have no objection to making application for security clearance, if necessary, signing an employee agreement on confidential information and inventions, or taking a medical examination. I understand also, that any consumption of any employee agreements is contingent upon successful completion of the background and investigation, and medical examination. I also understand that neither this employment application not acceptance of offer of employment by me constitutes in any respect an oral or written contract of employment.SignatureDate MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.
