JEFFREY L. DECKER - PROTECTING YOUR HOME AND FAMILY
EMPLOYMENT APPLICATION SUBMITION FORM
 
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!! NO PHONE CALLS !!
if interested in your qualifications we will call you
***experience will receive precedence***
Please submit all personal qualifications which you feel makes you the best candidate for the position or positions available.
 
ALL APPLICANTS SUBJECT TO DRUG TESTING AND BACKGROUND CHECKS
ON LINE APPLICATION:
NAME:
ADDRESS: INCLUDE (STREET, CITY, STATE AND ZIP)
PHONE NUMBER:
EMAIL ADDRESS:
SOCIAL SECURITY NUMBER:
DATE OF BIRTH:
ADDITIONAL LANGUAGES: WRITE / SPEAK FLUENTLY (IF BI-LINGUAL)
EXPECTED PAY:
PROFESSIONAL LICENSES HELD: (IF ANY)
CHECK ALL THAT APPLY
U.S. CITIZEN
1-3 YEARS EXPERIENCE:
3-6 YEARS EXPERIENCE:
6+ YEARS EXPERIENCE:
COMFORTABLE WITH HEIGHTS:
ABLE TO WORK WEEKENDS:
INTERESTED IN FULL TIME:
INTERESTED IN PART TIME:
VALID DRIVERS LICENSE:
CLEAN DRIVING RECORD: (if not explain below)
OWN VEHICLE:
VETERAN: (see 'Military Service History' below)
FELONY CONVICTIONS: (explain under qualifications)
MISDEMEANOR CONVICTIONS: (explain under quals.)
HIGH SCHOOL GRADUATE:
COLLEGE GRADUATE:
POST GRADUATE:
CURRENTLY EMPLOYED:
CURRENTLY ON UNEMPLOYMENT:
SUBJECT TO RECALL BY FORMER EMPLOYER:
PERMISSION TO CONTACT FORMER EMPLOYERS:
QUALIFICATIONS: MOST RECENT EMPLOYER: Name; Address; Phone Number; Dates of Employment; Job Title; Job Description; Supervisor; Ending Salary; Reason For Leaving
PREVIOUS EMPLOYER #2: (if less than 3 years at most recent)
PREVIOUS EMPLOYER #3: (if less than 3 years combined)
MILITARY SERVICE HISTORY: Branch; Rank; Dates of Service; Job Description; Type of Discharge (explain if other then honorable)
DRIVING RECORD HISTORY EXPLANATION:
REFERENCES: Please provide 3 professional references and 2 personal references, include: Name, Address, Phone Number, Company(if professional reference), Relationship(if personal reference), Number of years aquainted
Please write a sentence or two explaining why you feel, you are the best candidate for the position or positions available:
TIME OF APPLICATION:
Hours
 
 : 
Minutes
 
DATE OF APPLICATION:
DATE AVAILABLE:
By pressing [send], I (the applicant) certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
 
Thank you for your interest in working for our company
Jeffrey L. Decker is an Equal Opportunity Employer
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