Employment Form

* required field

PERSONAL INFORMATION:
Last Name:*
First Name:*
Middle Initial:
Present Address:*
City:*
State:*
Zip Code:*
Home Phone:
Alternative / Cell Phone:
Email:*
Have you ever used a different name for purposes of employment or education?:
If "YES" list name(s):
Are you under the age of 18?:
If under the age 18, do you have a work permit?:
If hired, can you provide verification of your legal right to work in the United States?:
Have you ever applied for a position at Hire Standards Pool Maintenance, Inc.?:
If "YES", give date(s) you applied?:
Do you have relatives employed by Hire Standards Pool Maintenance, Inc.?:
If "YES", please provide name(s):
Have you ever been convicted of a criminal offense (felony or misdemeanor)?:
If "YES", state nature of the crime(s), when and where convicted and disposition of the case. (Conviction will not necessarily bar you from employment):
Position(s) Desired:*
Type of Employment Desired:*	Full-Time Part-Time Temporary
Salary Desired (For example: $20 per hour):*
Date Available to Begin Work (mm/dd/yyyy):*
Are you able to perform the essential job functions of the position for which you are applying?:
If "NO", describe how you would perform the job with or without reasonable accommodation:
How did you learn of Hire Standards Pool Construction, Inc.?:*
If "OTHER", please specify:

EDUCATION, CERTIFICATION, SKILLS AND QUALIFICATIONS:
High School
Name and Location of School:
Course of Study:
Last Year Completed:
Degree or Diploma:
Trade School
Name and Location of School:
Course of Study:
Last Year Completed:
Degree or Diploma:
College/University
Name and Location of School:
Course of Study:
Last Year Completed:
Degree or Diploma:
Other
Name and Location of School:
Course of Study:
Last Year Completed:
Degree or Diploma:
Other
Name and Location of School:
Course of Study:
Last Year Completed:
Degree or Diploma:

List any professional certifications. licenses, or credentials you currently hold. Include the type of certification, issuing authority, or certification number and expiration date.
Type of Certification/License/Credential:
Issuing Authority:
Certification Number:
Expiration Date:

Type of Certification/License/Credential:
Issuing Authority:
Certification Number:
Expiration Date:

Type of Certification/License/Credential:
Issuing Authority:
Certification Number:
Expiration Date:

Type of Certification/License/Credential:
Issuing Authority:
Certification Number:
Expiration Date:

List Trade or Professional Organizations of which you are a member, including offices held:
List all office skills such as typing, shorthand, office machines, etc. (Describe level of competence):
Briefly describe how you are qualified for this position by virtue of your skills, training, aptitude, or internships which you have not had the opportunity to present elsewhere on this form.:

EMPLOYMENT INFORMATION:
Starting with the current or the most recent position, list all employment for the past ten (10) years. List all relevant experiences including paid employment, volunteer work, or work in the U.S. Armed Forces. Employment records will be verified.
May we contact your current employer?:
If "NO", why not?:

Job Title:
Date Employed From (mm/dd/yyyy):
Date Employed To (mm/dd/yyyy):
Start Salary:
Final Salary:
Employer Name:
Employer Address:
Employer Telephone:
Supervisor Name and Title:
Job Duties and Responsibilities:
Reason for Leaving:
Please explain gaps in employment (if applicable):

Job Title:
Date Employed From (mm/dd/yyyy):
Date Employed To (mm/dd/yyyy):
Start Salary:
Final Salary:
Employer Name:
Employer Address:
Employer Telephone:
Supervisor Name and Title:
Job Duties and Responsibilities:
Reason for Leaving:
Please explain gaps in employment (if applicable):

Job Title:
Date Employed From (mm/dd/yyyy):
Date Employed To (mm/dd/yyyy):
Start Salary:
Final Salary:
Employer Name:
Employer Address:
Employer Telephone:
Supervisor Name and Title:
Job Duties and Responsibilities:
Reason for Leaving:
Please explain gaps in employment (if applicable):

Job Title:
Date Employed From (mm/dd/yyyy):
Date Employed To (mm/dd/yyyy):
Start Salary:
Final Salary:
Employer Name:
Employer Address:
Employer Telephone:
Supervisor Name and Title:
Job Duties and Responsibilities:
Reason for Leaving:
Please explain gaps in employment (if applicable):

CERTIFICATION

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by Hire Standards Pool Maintenance, Inc. unless I have indicated to the contrary. I authorize the references listed to provide Hire Standards Pool Maintenance, Inc. any and all information concerning my previous employment and pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to Hire Standards Pool Maintenance, Inc. as well as from the use or disclosure of such information by Hire Standards Pool Maintenance, Inc. or any of its agents, employees or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired, my dismissal from employment.

In consideration of my employment, I agree to conform to the rules and standards of Hire Standards Pool Maintenance, Inc. I understand and agree that my employment with Hire Standards Pool Maintenance, Inc. or any of its affiliates is of an at will nature The employment relationship may be terminated at any time, with or without notice, and with or without cause, either at my option or at the option of Hire Standards Pool Maintenance, Inc. Nothing in this document or statement shall limit or modify the at will relationship. No manager, supervisor, or employee has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement for employment other than at will. Only the President of Hire Standards Pool Maintenance, Inc. has the authority to make any such agreement, and then only in written form and executed by the President. This at will agreement is the sole and entire agreement between Hire Standards Pool Maintenance, Inc. and employee concerning the duration of employment and the circumstances under which employment may be terminated. I agree that this shall constitute a final and fully binding integrated agreement with respect to the at will nature of my employment relationship and that there are no oral or collateral agreements regarding this issue.

I also understand that all offers of employment are conditioned on the provision of satisfactory proof of an applicant's identity and legal authority to work in the United States.

I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application. I declare under penalty of perjury that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for employment, and will be justification for my dismissal from employment, if discovered at a later date.

I confirm that I agree with the above statement

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