Step 1 of 7

First Name:

Middle Name:

Last Name:

Maiden Name:

Street Address:

Apartment:

City:

State:

Zip Code:

Primary Phone:

Secondary Phone:

Email:

Job Position:

How many hours are you available to work:

Are you able to work nights?

Yes No

When are you able to start?

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Step 3 of 7

Are you 21 years of age or older?

Yes No

Do you have a high school diploma, GED, or higher?

Yes No

Do you have a current and valid drivers' license?

Yes No

Are you willing to submit to a drug test?

Yes No

Are you willing to submit to a background test?

Yes No

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Step 4 of 7

Have you ever been convicted of a felony?

Yes No

If hired, can you provide proof that you are eligible to work in the U.S.?

Yes No

This job requires full time availability including work on Fridays, Saturdays, and Sundays, holidays, and overtime (45+ hours/week). Are you willing and able to meet these requirements?

Yes No

This job requires you to work in all weather conditions (extreme heat, cold, rain, snow). Are you willing and able to work in this environment?

Yes No

Do you have relatives employed at HPTS, INC.?

Yes No

If yes, who:

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Step 4a of 7

In the last 3 years, have you been convicted of a DUI or similar violation?

Yes No

Has you drivers' license been suspended for any moving violations in the last 3 years? (i.e. Speeding)

Yes No

This job requires you to climb a ladder to access roofs. Are you willing and able to meet the requirements?

Yes No

This job requires you to carry a ladder weighing up to 75 pounds, crawl in small spaces, and access roofs at varying heights. Are you willing and able to meet these requirements?

Yes No

Are you willing to submit to a pre-employment physical abilities screening to evaluate your ability to perform the job duties?

Yes No

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Step 5 of 7

Type of School	Name of School	Location	Years Completed	Major & Degree
High School
College
Trade School

Are you currently enrolled in school?

Yes No

If yes, when is your anticipated graduation date?

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Step 6a of 7 - Work Experience

Please list your last 3 employers

Employer		Employment Dates
Salary		Address
City		State
Zip		Phone Number
Name of Last Supervisor		Reason for leaving
List the jobs held, duties performed, skills used or learned, advancements of promotions while you worked at this company

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Step 6b of 7 - Work Experience

Please list your last 3 employers

Employer		Employment Dates
Salary		Address
City		State
Zip		Phone Number
Name of Last Supervisor		Reason for leaving
List the jobs held, duties performed, skills used or learned, advancements of promotions while you worked at this company

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Step 6c of 7 - Work Experience

Please list your last 3 employers

Employer		Employment Dates
Salary		Address
City		State
Zip		Phone Number
Name of Last Supervisor		Reason for leaving
List the jobs held, duties performed, skills used or learned, advancements of promotions while you worked at this company

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Step 7 of 7

Have you ever been in the military?

Yes No

Are you now a member of the national guard?

Yes No

What is be best way to reach you?

If you were referred by someone, who?

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Employment Application

Step 1 of 7

Step 2 of 7

Step 3 of 7

Step 4 of 7

Step 4a of 7

Step 5 of 7

Step 6a of 7 - Work Experience

Step 6b of 7 - Work Experience

Step 6c of 7 - Work Experience

Step 7 of 7