Referral Source*
State* AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Have you lived at the above address for three years or more? Did you live at this address for three years or more?
If you are under 18 and it is required, can you furnish a work permit? Do you have any friends or relatives employed by this company? Are you currently employed? If Yes, may we contact your present employer? Are you currently on “lay-off” status and subject to recall? Have you submitted an application here before? Have you ever been employed here before Are you legally eligible for employment in this country? (If hired, you will be required to submit a verification of your legal right to work in the United States.)
Type of employment desired Do you have any travel restrictions? Do you have reliable transportation to and from work every day? Do you have any restrictions on the hours you are able to work? Do you have a current Driver’s License (if relevant to position?) State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
First Aid Certification CPR Certification OSHA 10 Hour Construction Safety Certification OSHA 30 Hour Construction Safety Certification Are you fully able, with or without reasonable accommodation, to perform the essential functions of the job for which you applied?
READ AND UNDERSTOOD: Hidden
Educational Background (if Job Related)
Educational Background #1 State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Educational Background #2 State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Educational Background #2
Educational Background #3 State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Educational Background #3
Employment History #1 Currently Employed? State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Summarize the Type of Work Performed & Job Responsibilities
May we Contact for Reference Add Employment History #1
Employment History #2 Currently Employed? State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Summarize the Type of Work Performed & Job Responsibilities
May we Contact for Reference Add Employment History #2
Employment History #3 Currently Employed? State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Summarize the Type of Work Performed & Job Responsibilities
May we Contact for Reference Add Employment History #3 Hidden
Skills and Qualifications Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.
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Additional Information List special accomplishments, publications, awards, etc...
List any additional information you would like us to consider
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Applicant Acknowledgement and Signature Applicant Acknowledgement and Signature
I certify that all the information on this application is true and complete. I understand that any false information or omissions may result in
rejection of my application or, if I am hired, discipline up to and including termination. I understand my application is only valid for the
position for which I applied, and that Weaver Superior Walls, LLC is not obligated to retain or consider this application for future openings.
I authorize, to the extent allowed by federal, state, and local law:
Weaver Superior Walls, LLC to contact my references and confirm my employment history and education; and
My references and prior employers provide Weaver Superior Walls, LLC information regarding my employment history and
qualifications without giving me prior notice.
In addition, I release Weaver Superior Walls, LLC, my former employers and all other persons, corporations, partnerships and
associations from any and all claims, demands or liabilities arising out of related to such investigation or disclosure.
I understand that this application is not an offer of employment and that any job offer is conditional pending the results of postoffer, pre-employment investigations as described herein. I further understand that:
If I am hired by the Company, I will be an at-will employee , meaning that either the Company or I may end the employment
relationship at any time with or without cause.
Any job offer will be in writing, signed by Weaver Superior Walls, LLC’s President or Human Resources Administrator. No other
Company representative has authority to enter into an employment agreement or alter the at-will relationship.
Post-Offer, Pre-Employment Inquiries
If I am extended an offer of employment by Weaver Superior Walls, LLC, I agree to:
Undergo a physical examination which is job related and consistent with federal and state law;
Submit to a pre-employment drug testing as described in the Drug and Alcohol Testing Authorization.
Additionally, I understand that Weaver Superior Walls, LLC will ask about criminal convictions if relevant to the job at issue, in
accordance with state and federal law, and that Weaver Superior Walls, LLC will follow Pennsylvania’s Clean Slate Law (18 Pa.C.S.
§9121 - §9125) for any criminal records inquiry.
Weaver Superior Walls, LLC will consider the facts and circumstances in evaluating the results of an applicant’s physical examination,
drug test or criminal conviction. I acknowledge that, to the extent permissible by law, however, Weaver Superior Walls, LLC has sole
discretion to revoke a conditional offer of employment.
By signing below, I agree to be bound by the terms and conditions in this application, which contains the complete
understanding between the Company and me, replacing any prior inconsistent understandings regarding such issues.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT ACKNOWLEDGEMENT Hidden
Drug and Alcohol Testing Authorization