☎ 806-763-3988 Home About us Perma-liner HVAC Plumbing Other Services Gallery Contact us Blog Download Full Job Application Job Application Last Name First M.I. Date: Street Address City State ZIP Phone Email SSN Date of Birth DL # & State Date Available Desired Salary New Field: Are you a citizen of the United States Yes No If no, are you authorized to work in the U.S.? Yes No Have you ever worked for this company? Yes No If so, when? Have you ever been convicted of a felony? Yes No If yes, explain Have you ever been convicted of a misdemeanor? Yes No If yes, explain Have you had any driving violation in the last 2 years? Yes No If yes, explain Education Highest Level of Education High School College Other School Address New Field: To Did you graduate? Yes No Degree Please list three professional references. Reference #1 Full Name Relationship Company Phone Reference #2 Full Name Relationship Company Phone Reference #3 Full Name Relationship Company Phone Previous Employment Company #1 Phone Address Supervisor Job Title Starting Salary $ Ending Salary $ Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No Company #2 Phone Address Supervisor Job Title Starting Salary $ Ending Salary $ Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No Company #3 Phone Address Supervisor Job Title Starting Salary $ Ending Salary $ Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No Military Service Branch From To Rank at Discharge Type of Discharge If other than honorable, explain Describe any specialized training, apprenticeship, skills and extra-curricular activities. Describe any job-related training received in the United States Military. List Professional, trade, business or civic activities and offices held. Best time to contact you is at Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hearby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. If the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Signature Date ☎ 806-763-3988 joerushingpha1948@gmail.com HOURS 24/7 Emergency Service Monday To Friday: 8:00AM-5:00PM Saturday & Sunday: Emergencies Only Lic. #TACLA002434C #M-12383 **Regulated by Texas Department of Licensing and Regulations** P.O. Box 12157 Austin, TX 78711 **Texas State Board of Plumbing Examiners** P.O. Box 4200 Austin, TX 78765 1-800-845-6584 Copyright © 2020 Joe Rushing, all rights reserved.