EMPLOYMENT APPLICATION

Please complete the entire application

EMPLOYER INFORMATION

S&B Plumbing LLC

*** * **** * *** A

Marriott Slaterville, Utah 84404

Telephone: 801-***-****

It is policy of S&B Plumbing to provide equal employment opportunities to all applicants and employees without regards to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status. APPLICANT INFORMATION

Applicant Full Name: Home Address: City, State Zip: Number of years at this address:

Phone Number: Is this a cell number? Yes No Social Security Number: Drivers License Number: State of Issue: Expiration Date: Position Applying For: Salary Desired: $ per Are You At Least 18 Years Old? Yes No

Are You Available To Work Overtime? Yes No If You Are Offered Employment, When Would You Be Available to Start? If Hired, Are You Able to Submit Proof That You Are Legally Eligible for Employment in the United States? Yes No

Have You Ever Been Convicted of a Felony or Misdemeanor? Yes, I was convicted of on (date) in (city) (state) No

THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT. APPLICANT’S SKILLS

PLUMBING EXPERIENCE: (years) (months) Please Describe: OTHER EXPERIENCE RELEVANT TO POSITION: APPLICANT’S EDUCATION AND TRAINING

HIGH SCHOOL/GED

School Name and Location: Did you graduate or receive a GED: Yes No COLLEGE/UNIVERSITY

School Name and Location: Did you receive a degree: Yes No

Course of study: Other Training (graduate, technical, vocational):

Please list any current professional licenses or certification that you hold: Awards, Honors, Special Achievements:

APPLICANT EMPLOYMENT HISTORY

List your current or most recent employment first. Please list all jobs (including self- employment and military service) which you have held beginning with the most recent. List and explain any gaps in employment. If additional space is needed, continue on the back page of this application.

Employer Name: Supervisor Name: Address: City/State/Zip: Job Duties: Reason for Leaving: Dates of Employment (Month/Year): Employer Name: Supervisor Name: Address: City/State/Zip: Job Duties: Reason for Leaving: Dates of Employment (Month/Year): Employer Name: Supervisor Name: Address: City/State/Zip: Job Duties: Reason for Leaving: Dates of Employment (Month/Year): REFERENCES

List any two non-relatives who would be willing to provide a reference for you. Name: Address: City/State/Zip: Telephone: Email: Relationship: Name: Address: City/State/Zip: Telephone: Email: Relationship: Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current/previous employer: CERTIFICATION

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination. I authorize S&B Plumbing to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance and grades. I authorize those persons designated as reference to fully and freely communicate information regarding my previous employment and education. I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.

APPLICANT SIGNATURE DATE