* denotes required field 

    General Information

     

     

    *

    Job You are Applying For:

    *

    First Name:

    *

    Last Name:

    *

    Home Phone:

    Street Address:

     

    City:

    State:

    Zip:

    *

    Email:

    Legal Residence

    (if different):

     


    Work History

     

     

    Experience and Employment. Please start with current or last position. Minimum of 3 verifiable past employers required.

     

    Employer 1

     

    Employer Name:

    Address:

    City:

    State:

    Telephone Number:

    Immediate Supervisor:

    Dates:

    to

    Duties:

    Reason for leaving:

     

    Employer 2

     

    Employer Name:

    Address:

    City:

    State:

    Telephone Number:

    Immediate Supervisor:

    Dates:

    to

    Duties:

    Reason for leaving:

     

    Employer 3

     

    Employer Name:

    Address:

    City:

    State:

    Telephone Number:

    Immediate Supervisor:

    Dates:

    to

    Duties:

    Reason for leaving:

     


    Other References

     

    Please do not list family members or relatives.

     

    Name:

    Phone Number:

    Address:

     

     

     

     

    Name:

    Phone Number:

    Address:

     

     


    Do you have friends or relatives working for Reed & Reed? (If yes, please name)

     

    Name:

    Relationship:

    Name:

    Relationship:


     

     

    In case of Emergency, notify:

    Name:

    Relationship:

    Address:

     

    City:

    State:

    Phone Number:


     

     

    Were you refered by a current Reed & Reed employee? (If yes, name)

     

    If yes, name:

     


     

     

    How soon are you available to start work?

     

    Date:

     


     

     

    If hired, you would be asked to work Monday through Friday, from 7:00 a.m. to 4:30 p.m. Are you able to meet this schedule?

     

     

     


     

     

    If hired, would you be willing to travel to different job locations throughout the state?

     

     

     


     

     

    Do you have a valid drivers license that is current AND reliable transportation? If NO - how will you get to work on time every day?

     

     

     


     

     

    Current Licenses and Certifications held: (Ex: WD Certs, Electrical License, etc.)

     

     

     


     

     

     


     

     

    Do you have any special skills?

     

     


    Substance Abuse Screen

     

     

    I hereby consent to urine substance abuse testing for the purpose of detecting drugs of abuse. I acknowledge that my prosepective employer, Reed & Reed, Inc. will request this test and upon my request will provide me with a copy of their Substance Abuse Program Policy. I understand that Reed & Reed, Inc. will deny employment to any person whose substance abuse screen is positive.

     

     

     


     

     

    Voluntary Affirmative Action Info

     

     

    Instructions to Applicant:

    Reed & Reed, Inc., is an Equal Opportunity Affirmative Action Employer. The information solicited on this page is being compiled to comply with federal record-keeping regulations and EEO/Affirmative Action requirements. The information provided on this form is CONFIDENTIAL. This page will be removed from your application prior to review and will not be a part of your application for employment or personnel file. Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA ON THIS PAGE WILL NOT AFFECT ANY EMPLOYMENT DECISION.

     

    Name:

    Date of Birth:


     

     

    Please check applicable answers

     

     

     


     

     

    Referral Source

     

     

     

     

    Name of Current Employee:

     

     

    Other Referral:

     


     

     

    Check answers which apply to you:

     

     

     

     

     

    I agree that any false statement in this application shall be sufficient cause for rejection or dismissal and hereby grant permission to investigate any information included in this application.

    I hereby authorize Reed & Reed to check court records, drivers license records, and credentials in connection with my application for employment with this company. I hereby release Reed & Reed from any and all liability of any type in connection with the obtaining of this information.

     

     

     

    I understand that by submitting this application, I agree to the terms stated above.

     

     


    Attach resume (optional, must be less than 2mb. File types accepted: .pdf, .txt, .doc, .docx)

     

     

     

    captcha

    Enter the code above (to prevent spam):