RESIDENTIAL COMMERCIAL ABOUT FIELD DIVISIONS SERVICES PORTFOLIO REQUEST INFO By completing this application below you are seeking to join a team of hardworking professionals who are dedicated to consistently delivering outstanding service to our clients and who contribute to the financial success of this company. [ DOWNLOAD APPLICATION ] *REQUIRED FIELDS APPLICANT INFORMATION Last Name * First Name * M.I. Today’s Date Street Address * Apartment/Unit # City * State -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Phone * E-mail Address * Date Available Desired Salary * Position Applied for * 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 N&B before? Yes No If so, when? Do you have friends/family working for N&B? Yes No Name? Do You have a valid drivers License? Yes No EDUCATION College Address From To Did you graduate? Yes No Degree High School Address From To Did you graduate? Yes No Degree Other Address From To Did you graduate? Yes No Degree MILITARY SERVICE Branch From To Rank at Discharge Type of Discharge If other than honorable, explain REFERENCES Please list three professional references (non-family, familiar with your work abilities who’ve known you more than one year). Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address Full Name Relationship Company Phone Address MOST RECENT OR RELEVANT EMPLOYER Company Phone Address Supervisor Job Title Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No SECOND MOST RECENT OR RELEVANT EMPLOYER Company Phone Address Supervisor Job Title Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No THIRD MOST RECENT OR RELEVANT EMPLOYER Company Phone Address Supervisor Job Title Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference? Yes No COMPUTER SKILLS (Include software titles and years of experience) Word Processing Years E-Mail Years Spreadsheet Years Internet Years Presentation Years Other Years OTHER INFORMATION YOU WOULD LIKE US TO KNOW ABOUT YOUR QUALIFICATIONS DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature * Date * IMPORTANT INFORMATION TO THE APPLICANT NAYLOR & BREEN BUILDERS, INC. IS AN EQUAL OPPORTUNITY EMPLOYER. WE DO NOT DISCRIMINATE IN HIRING OR EMPLOYMENT IN ACCORDANCE WITH THE REQUIREMENTS OF ALL APPLICABLE LOCAL, STATE AND FEDERAL LAWS, ON THE BASIS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, AGE, VETERAN STATUS OR PHYSICAL OR MENTAL DISABILITY OR ANY BASIS OTHER THAN FACTORS THAT AFFECT THE ABILITY TO PERFORM THE WORK REQUIRED. THERE ARE PRE-CONDITIONS FOR EMPLOYMENT. WE RESERVE THE RIGHT TO PERFORM DRUG OR ALCOHOL TESTING AND/OR BACKGROUND INVESTIGATIONS. WE ASK YOUR PERMISSION TO CONDUCT SUCH TESTING PRIOR TO EMPLOYMENT AND ANY TIME THAT SUCH FACTORS MAY AFFECT WORK PERFORMANCE OR POSSIBLY BE RELATED TO ANY ACCIDENT OR INCIDENT. YOUR PERMISSION IS IMPLIED BY THIS APPLICATION. THE USE, POSSESSION, OR BEING UNDER THE INFLUENCE OF ILLEGAL DRUGS OR ALCOHOL WHILE ON COMPANY TIME IS PROHIBITED. IN ADDITION, BEING UNDER THE INFLUENCE OF LEGALLY PRESCRIBED MEDICATION THAT CAUSES EITHER PHYSICAL OR MENTAL IMPAIRMENT OF JUDGMENT FOR WORK PERFORMANCE WHILE ON COMPANY TIME IS ALSO PROHIBITED. IF YOU ARE HIRED, YOU WILL BE REQUIRED TO PROVIDE A COPY OF YOUR DRIVER’S LICENSE, PROOF OF LEGALITY TO WORK IN THE UNITED STATES (INS FORM I-9), AN INCOME TAX DEDUCTION FORM (W-4), AND OTHER PERSONAL CONTACT AND HEALTH RELATED INFORMATION. EMPLOYMENT APPLICATION MATERIALS WILL BE KEPT ON FILE FOR ONE YEAR. 191 ALTA WOODS / BRANDON, VERMONT 05733 PH: 802.247.6527 / FX: 802.247.0048 © 2018 NAYLOR & BREEN BUILDERS, INC. SITE BY: JEG DESIGN INC PHOTOGRAPHY CREDITS