Application for Employment

All applicants for employment are required to complete and submit this Employment Application.

If you need more time to fill out this application, it can be saved as a draft for 30 days. “Save as draft” button is located at the bottom of this form.

Applicant Information

Prefix

First Name *LEGAL NAME as shown on Social Security Card

Middle Name *LEGAL NAME as shown on Social Security Card

Last Name *LEGAL NAME as shown on Social Security Card

Social Security NumberNumbers only, no dashes.

Have you ever worked under another name?YesNo

If so, what name(s)?

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Home Phone

Cell Phone

Email address

Position Applying For

JOB APPLYING FOR *COUNTER SALES ASSOCIATE - PLUMBERS WHOLESALE SUPPLY/PARK SUPPLY TUSCALOOSA LOCATIONDELIVERY DRIVER - HUNTSVILLE LOCATIONDELIVERY DRIVER - PLUMBERS WHOLESALE SUPPLY/PARK SUPPLY TUSCALOOSA LOCATIONINSIDE SALES - PLUMBERS WHOLESALE SUPPLY/PARK SUPPLY PELHAM LOCATIONSHOWROOM SALES CONSULTANT - PLUMBERS WHOLESALE SUPPLY/PARK SUPPLY TUSCALOOSA LOCATIONWAREHOUSE/DELIVERY DRIVER - ATHENS LOCATION

DESIRED SALARY

USD

AVAILABLE START DATE

WILL YOU BE ABLE TO PERFORM THE ESSENTIAL JOB FUNCTIONS FOR THE POSITIONS YOU ARE APPLYING FOR WITH OR WITHOUT REASONABLE ACCOMMODATION?

FULL TIMEYESNO

PART TIMEYESNO

OVER TIMEYESNO

TEMPORARYYESNO

IF NO, DESCRIBE THE FUNCTION(S) THAT CAN'T BE PERFORMED:

IF EMPLOYED, CAN YOU SUBMIT VERIFICATION OR YOUR LEGAL RIGHT TO WORK IN THE US?YESNO

HAVE YOU WORKED FOR OR APPLIED FOR A POSITION AT THIS COMPANY BEFORE?YESNO

DO YOU HAVE ANY RELATIVES WORKING HERE?YESNO

HOW DID YOU LEARN ABOUT THIS OPENING?

ARE YOU 18 YEARS OF AGE OR OLDER?YESNO

IF UNDER 18, DO YOU HAVE A WORK PERMIT?YESNO

HAVE YOU EVER BEEN CONVICTED OF A CRIME?YESNO

IF YES, PLEASE DESCRIBE THE NATURE OF THE CRIME(S), THE DATE AND PLACE OF CONVICTION AND THE LEGAL DISPOSITION OF THE CASE. THE COMPANY WILL NOT DENY EMPLOYMENT TO ANY APPLICANT SOLELY BECAUSE THE PERSON HAS BEEN CONVICTED OF A CRIME. THE COMPANY, HOWEVER, MAY CONSIDER THE NATURE, DATE, AND CIRCUMSTANCES OF THE OFFENSE AS WELL AS WHETHER THE OFFENSE IS RELEVANT TO THE DUTIES OF THE POSITION APPLIED FOR.

EDUCATION

BEGIN WITH THE MOST RECENT COLLEGE/UNIVERSITY/TECHNICAL SCHOOL

1. NAME OF EDUCATIONAL INSTITUTION/LOCATION

NUMBER OF YEARS

DID YOU GRADUATE?YESNO

MAJOR

DIPLOMA/DEGREE OBTAINED

2. NAME OF EDUCATIONAL INSTITUTION/LOCATION

NUMBER OF YEARS

DID YOU GRADUATE?YESNO

MAJOR

DIPLOMA/DEGREE OBTAINED

3. NAME OF EDUCATIONAL INSTITUTION/LOCATION

NUMBER OF YEARS

DID YOU GRADUATE?YESNO

MAJOR

DIPLOMA/DEGREE OBTAINED

4. NAME OF EDUCATIONAL INSTITUTION/LOCATION

NUMBER OF YEARS

DID YOU GRADUATE?YESNO

MAJOR

DIPLOMA/DEGREE OBTAINED

ANY PROFESSIONAL DESIGNATIONS OR OTHER TRAINING/EDUCATION RELATED TO THE JOB YOU ARE APPLYING FOR?

EMPLOYMENT HISTORY

LIST CURRENT/MOST RECENT POSITION FIRST

COMPLETE ALL JOB HISTORY REGARDLESS OF RESUME ATTACHMENT

MAY WE CONTACT YOUR CURRENT EMPLOYER?YESNO

1. NAME OF EMPLOYER

DATES EMPLOYED

ADDRESS/LOCATION

TYPE OF BUSINESS

POSITION/TITLE

SALARY

USD

MANAGER'S NAME

MANAGER'S TITLE

PHONE NUMBER

REASON FOR LEAVING

2. NAME OF EMPLOYER

DATES EMPLOYED

ADDRESS/LOCATION

TYPE OF BUSINESS

POSITION/TITLE

SALARY

USD

MANAGER'S NAME

MANAGER'S TITLE

PHONE NUMBER

REASON FOR LEAVING

3. NAME OF EMPLOYER

DATES EMPLOYED

ADDRESS/LOCATION

TYPE OF BUSINESS

POSITION/TITLE

SALARY

USD

MANAGER'S NAME

MANAGER'S TITLE

PHONE NUMBER

REASON FOR LEAVING

RESUMES WELCOME - UPLOAD HERE

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APPLICANT'S CERTIFICATION AND RELEASE

I certify that the facts given in my resume and/or Application for Employment are true and correct. I understand that if employed, any false or misleading statements, omissions, or failure to fully answer any requested item on this application or on any document used to secure employment shall be grounds for rejection of this application or for my termination from employment, if i am employed, regardless of when such information is discovered. I authorize the Company to secure background information on my work record, education, and other matters related to my suitability for employment. I authorize my references and background sources to disclose information about me to the Company, without giving me prior notice of such disclosure. I hereby release the Company, my former employers, and all other sources from any and all claims, demands, or liabilities arising out of or in any way related to securing such information or disclosures. I understand that nothing contained in the application, or information conveyed during any interview, which may be granted, or during my employment, if hired, intended to create an employment contract between the Company and me. I understand that any employment with this Company is "at will", which means that either I or the Company can terminate the employment relationship at any time with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of the Company has any authority to alter the foregoing unless a specific term of employment is in writing and signed by the Company President.

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