How did you hear about us?
Email Address *
Phone Number *
Last Name *
First Name *
Social Security Number
Are you under 18 years of age?
Position Applied For *
Desired Wage *
Full Address (Street/City/State/Zip) *
How Long at Current Address *
Employment Desired *
When Available to Begin Work? *
Type of School
Name of School
Major / Degree
Bus. Or Trade School
Have you ever been convicted of a crime?
What was the conviction?
A Conviction record will not necessary disqualify you for employment.
Have you ever been in the Armed Forces?
Are you now a member of the armed forces?
Please clearly state in the box below if you are not able to perform any of the work duties listed above. After reviewing the attached job description, please indicate if you are able to perform the essential functions of the job for which you have applied, with or without a reasonable accommodation. Please write in the box below if you will need any accommodations.
Name of Employer
Reason for Leaving
Name of Employer Number
Can we Contact
I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.
We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, height, weight, or disability. We assure you that your opportunity for employment with us depends solely on your qualifications.
Thank you for completing this application form and for your interest in P & P Home Services, LLC. If there are any questions, please call P & P Home Services, LLC at (317) 591-9234
Applicant Signature *