Application

Nelson Plumbing

Employment Application Form

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Nelson Plumbing, Inc.

11590 Davis Creek Road E.

Jacksonville, Florida 32256

Office: (904) 262-4884

Nelson Plumbing is currently looking for dependable qualified Journey Plumbers with a proven track record. You must have a valid drivers license and have a strong work ethic.

Nelson Plumbing is an EOE (Equal Opportunity Employer). This is a pre-employment questionnaire to gather information about you in order to determine if an in-person interview will be granted. You must answer all information asked on this form and of course all answers must be truthful.

If after reviewing information, we will contact you for interview. Do not call the office to check on the status of your application. If you do not hear from us, there were or are reason we are not interested at this time. However, we will retain all applications for consideration in the future.

Pre-Employment Application

Name (Last name first)	Soc Sec No
Address	Phone Number
What kind of work are you applying for?
What special qualifications do you have?
Are you 18 years or older?	Yes No - Date of Birth:
Are you a US Citizen or an Alien authorized to work in the US?	Yes No
Have you been convicted of a Felony or Misdemeanor within the last 5 years?	Yes No - If yes, describe:
What is the highest level of education you have earned?	High SchoolSome CollegeAA Degree4 Yr DegreeDid not graduate from HS
Work Experience: Please list the name of the company, date of employment, salary range and reason for leaving.
Business References: Please list the name, occupation and phone number.

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

The Age Discrimination In Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.