* 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.)
 
   

 
  Are you a convicted felon?
 
   

 
  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)
   
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