Heritage Building Maintenance, LLC - Employment Application


    Please fill out the form below as thoroughly as possible and submit for employment consideration with Heritage Building Maintenance, LLC.

    Items marked with an asterisk (*) are required.

    Applicant Information

    First Name:*   Last Name:*   Middle Initial:

    Street Address:*   Apartment/Unit#:

    City:*

    State:*

    ZIP Code:*

    Phone:*

    E-mail Address:

    Date you will be available for employment:*

    IMPORTANT: Background checks are performed on all applicants.

    Driver's License No: (if applicable)

    Position Applied For:

    Are you authorized to work in the United States?*

    noyes

    Have you ever worked for Heritage Building Maintenance, LLC?*

    noyes

    If you answered yes, when? (please provide a date)

    Have you ever been convicted of a felony?*

    noyes

    If you answered yes, please explain:


    Education Information

    High School:   Dates Attended: From:   To:


    Did you graduate?

    noyes

    College:   Dates Attended: From:   To:


    Did you graduate?

    noyes

    Trade or Technical School:   Dates Attended: From:   To:


    Did you graduate?

    noyes


    Professional References

    Please List three professional (non-related) references.

    Reference 1:

    Full Name:*   Relationship:*


    Company:*   Phone*:


    Address:*


    Reference 2:

    Full Name:   Relationship:


    Company:   Phone:


    Address:


    Reference 3:

    Full Name:   Relationship:


    Company:   Phone:


    Address:


    Previous Employment

    Employer 1:

    Company:*   Phone*:


    Starting date at this employer:*   Ending date at this employer*:


    Reason for leaving:*


    Address:*   Supervisor*:

    Job Title:   Starting Wage: $ /hr.   Ending Wage: $ /hr.


    Employer 2:

    Company:   Phone:


    Starting date at this employer:   Ending date at this employer:


    Reason for leaving:


    Address:   Supervisor:

    Job Title:   Starting Wage: $ /hr.   Ending Wage: $ /hr.


    Employer 3:

    Company:   Phone:


    Starting date at this employer:   Ending date at this employer:


    Reason for leaving:


    Address:   Supervisor:

    Job Title:   Starting Wage: $ /hr.   Ending Wage: $ /hr.


    Background Check Authorization and Information

    (please fill out as completely as possible)

    Maiden Name, Previous Names, or Aliases Used: (if different from what was entered above)

    First Name:   Last Name:   Middle Initial:


    First Name:   Last Name:   Middle Initial:


    First Name:   Last Name:   Middle Initial:


    First Name:   Last Name:   Middle Initial:

    DATE OF BIRTH*:


    SOCIAL SECURITY NUMBER*:


    Please provide ALL residential addresses for the past seven (7) years.


    Current Address: How long have you been at your current address (listed above)? From:


    Previous Address: | From/To:


    Previous Address: | From/To:


    Previous Address: | From/To:


    Previous Address: | From/To:


    Previous Address: | From/To:


    Previous Address: | From/To:

    TODAY'S DATE:*


    Disclaimer & Acknowledgement

    I understand that the employer follows an employment-at-will policy, in that I or the employer may terminate my employment at any time, and for any reason consistent with applicable state and federal laws. I understand that this application is not a contract of employment. I understand that to be employed I must be lawfully authorized to work in the United States, and I must show the employer documents that will prove this if I am offered the job.
    I understand that the company will thoroughly investigate my work and personal history and verify all data given on the application, on related papers, and in interviews. I satirize all individuals, schools, and firms named within to provide any information requested about me, and I release them from all liability for damage in providing this information.
    I certify that all the statements herein are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal of employment.

    By checking the box, you fully understand and accept the terms outlined above.


    Please provide your initials for validation.*


    Please check the box below for security purposes.


    Your information is safe with us. All data and information supplied through this site is handled securely. We will never share your personal information with third parties or anyone outside the members of Heritage Building Maintenance, LLC.