Application – Chris' Plumbing

Date
MM slash DD slash YYYY
Personal
Full Name (First + Middle + Last)*
Permanent Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone*
Email Address*
How did you hear about our company?
Employment Information
Date of Birth
MM slash DD slash YYYY
Do you have the legal right to live and work in the U.S.?*
- Yes
- No
Social Security Number
Citizenship/Work Status*
- U.S. Citizen
- Green Card Holder
- U.S. Work Permit/Visa
- Canadian Citizen
- Canadian Work Permit/Visa
Other name(s) under which you have been previously employed
Current Employer (if applicable)
What Position are you applying for?
Years of Work Experience directly related to the position you are applying for*
Employment Type Desired:*
- Full-Time
- Part-Time
Desired Compensation*
Please note Hourly or Annual
Other Compensation Desired:
When are you available to start work?*
MM slash DD slash YYYY
Education

Where did you attend high school & college/trade school?*

(Click the + button to add a new row)

Type of School	Name of School	Location	# of Years Completed	Major & Degree

Are you taking any educational course(s) presently?*
- Yes
- No
- I will be soon
If Yes or you will be soon, what and where?
Criminal History
Have you ever been convicted of a felony or misdemeanor (except any minor traffic violations)?*
- No
- Yes
If yes, please explain and attach any relevant documentation below. Be sure to list dates, offenses, and disposition.
Convictions are not an automatic disqualification from employment.
File
Max. file size: 496 MB.
Driver's License Information
Do you have a valid Driver's License?*
- Yes
- No
Do you have reliable transportation to work (please be specific)?
Driver's License Number
Driver's License State of Issue
Driver's License Type
- Operator
- Commercial (CDL)
- Chauffeur
Do you have a clean driving record?*
- Yes
- No
List any Moving Violations and/or Accidents from the last 3 years:
Military Service
Have you ever served in the U.S. Armed Services?*
- Yes
- No
Branch:
Are you currently a member of the National Guard or Reserves
- Yes
- No
Specialty
Date Entered
MM slash DD slash YYYY
Discharge Date
MM slash DD slash YYYY
Work Experience
Please list your work experience for the past 5 years, beginning with your MOST RECENT job. If you were self-employed, give firm name. There is also a place at the end to upload your resume, if applicable.
Name of Employer (Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor's Name & Title

Dates Employed

From	To

Base Rate of Pay (Hour/Week/Month)

Start	End

Job Title
Reason for Leaving?
Description of duties
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer?
- Yes
- No
Did you have another job before this one?*
- Yes
- No
Name of Employer (Second Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor's Name & Title

Dates Employed

From	To

Base Rate of Pay (Hour/Week/Month)

Start	End

Job Title
Reason for Leaving?
Description of duties
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer?
- Yes
- No
Would you like to list another previous job?
- Yes
- No
Name of Employer (Third Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor's Name & Title

Dates Employed

From	To

Base Rate of Pay (Hour/Week/Month)

Start	End

Job Title
Reason for Leaving?
Description of duties
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer?
- Yes
- No
Would you like to list a 4th job?
- Yes
- No
Name of Employer (Fourth Most Recent)
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Supervisor's Name & Title

Dates Employed

From	To

Base Rate of Pay (Hour/Week/Month)

Start	End

Job Title
Reason for Leaving?
Description of duties
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer?
- Yes
- No
Plumbing Industry Skills
ONLY select the specific industry skills that you consider yourself to be VERY knowledgeable about, with a HIGH level of competency.
What types of systems have you worked with?
(Select all that apply)
- Backflow Prevention
- Boilers
- Chilled Water
- Chillers
- Circulating Systems
- Cold Water Systems
- Compressed Air Systems
- Distribution Systems
- Drainage Systems
- Fire Sprinkler Systems
- Geo Thermal
- Heating Systems
- Hot Water Systems
- Hydronic
- In-Floor
- Irrigation Systems
- Medical Gas Systems
- Radiant Heating
- Sanitation Systems
- Septic Systems
- Storm Drainage Systems
- Water Conditioners
- Water Filtration Systems
- Water Heaters
- Water Purification Systems
- Well Water Systems
What types of pipe and lines have you worked with?
(Select all that apply)
- ABS Pipe
- Air Lines
- Black Iron Pipe
- Cast Iron Pipe
- Copper Pipe
- CPUC Pipe
- DMV Pipe
- FIP (Female Iron Pipe)
- Flexible Hoses
- Fuel
- Galvanized Pipe
- Glass Pipe
- Hydraulic Lines
- IPS (Iron Pipe Size)
- Lead Pipe
- LPG (Liquid Propane Gas)
- MIP (Male Iron Pipe)
- Natural Gas
- Oil
- Oxygen Lines
- Pneumatic Lines
- Propane
- PVC Pipe
- Sanitary Lines
- Sewer Line
- Steel Pipe
- Supply Lines
- Vacuum Lines
- Vitrified Clay Pipe
- Water
What Applications do you have experience with?
(Select all that apply)
- Aircraft
- Clean Rooms
- Commercial
- Floating Floor
- Government Projects
- Grocery Stores
- Hospitals
- Industrial
- Marine
- Multi-Family
- Off-Shore
- Pools
- Public Utilities
- Residential
- Restaurants
- Schools
What specific parts, pumps, valves, fittings, etc. have you worked with?
(Select all that apply)
- Aerator
- Air Admittance Valves
- Air Gaps
- Ball Valves
- Bath Tubs
- Bidets
- Closet Flanges
- Commodes
- Compressors
- Dish Washers
- Diverter
- Dual Check Valves
- Fittings
- Fixed Flow Restrictors
- Fixtures
- Flange
- Garbage Disposals
- Grease Traps
- Ice Machines
- Instant Hot Water
- Interceptors
- Leaders
- Lift Stations
- Lint Traps
- Mixing Valves
- PEX insert fittings and valves
- Pressure Balance Valve
- Pressure Reducing Valves
- Pumps
- Roof Drains
- Separators
- Sewage Ejectors
- Showers
- Sinks
- Sump Pumps
- Supply Stops
- Thermostatic Valve
- Traps
- Urinals
- Vacuum Breaker
- Valves
- Vent
- Water Hammer Arrestors
What Job Functions have you performed?
(Select all that apply)
- Activity Reporting
- Activity Tracking
- Advertising (broadcast)
- Advertising (online)
- Advertising (print)
- Assembling
- Backflow
- Brazing
- Budgeting
- Building Codes
- Business Development
- Call Center Management
- Carpentry
- Change Orders
- Channel Development
- Chemical Drain Treatment
- Chemical Septic Tank Treatment
- Clamping
- Client Interaction
- Client/Account Management
- Cold Calling
- Commission Development
- Computer Literate
- Consultative Selling
- Contract Negotiations
- Contract/Proposal Preparation
- Conventions/Trade Shows
- Cross Connection
- Customer Service
- Cutting Torch
- Data Entry
- Department Forecasting
- Design/Build
- Designer
- Develop Relationships/Alliances
- Dispatcher
- Drafting
- Draftsman
- Drain Cleaning
- Driving
- Drywall Repair
- Engineer/PE
- Estimator
- Executive
- Expense Reports
- Facility Manager
- Field Supervisor
- Flaring
- Forecasting
- Foreman
- Four-Wheel Steel Pipe Cutter
- Gasket Join
- General Construction
- General Manager
- Gluing
- Goal Setting
- Hydro Jetting
- Hydrostatic Testing
- Inspector
- International
- International Plumbing Code
- Inventory Control
- Journeyman
- Layout
- Lead Generation
- Lead Management
- Lead Oakum Joint
- Leadership
- Leak Detection
- Leak Detection Equipment
- Machine Operator
- Maintenance
- Maintenance - Apartment
- Manager
- Manufacturer Rep
- Market Analysis
- Material Handler
- National Standard Plumbing Code
- Negotiate Contracts
- NFSA Apprentice Program
- OEM
- One-Wheel Steel Pipe Cutter
- Operate Power Tools
- Operations Manager
- P&L
- PHCC Apprentice Program
- Pipe Bending
- Pipe Cutting
- Pipe Joining
- Pipe Threading
- Pipe Threading Machine
- Piping
- Plan-O-Grams/Schematics
- Plan/Spec
- Policy/Procedure Development
- Power Driven Vise Stand
- Power Tools
- Prepare Financial Reports
- Presentation Preparation
- Preventative Maintenance
- Product Demonstration
- Production
- Production Specialist
- Project Management
- Project Scheduling
- Promotions Development
- Proposal Development
- Proposal Presentation
- Prospecting/Lead Generation
- Punch List
- Purchase Orders
- Purchasing
- Quality Assurance/Control
- Re-Piping
- Report Generation
- Reporting
- Research
- Rough-In
- Safety Coordinator
- Sales
- Sales - In Home
- Sales - Residential
- Sales - Retail
- Sales - Wholesale
- Sales Management, Area
- Sales Management, National
- Sales Management, Regional
- Sales Training Development
- Service
- Service Agreements
- Sewer Snakes
- Shipping Coordination
- Shipping/Receiving
- Sizing Pipes
- Soldering
- Staffing
- Steamfitter
- Strategic Alliances
- Superintendent
- Supervision
- Take-offs
- Team Building
- Technician
- Telemarketing - Inbound
- Telemarketing - Outbound
- Territory Management
- Trainer
- Troubleshooting
- Tubing Cutter
- ULF (Ultra Low Flush)
- Under Slab Re-Route
- Under Slab Repairs
- Uniform Plumbing Code
- Vendor Coordination
- Water Service
- Welding
What Computer related experience do you have?
(Select all that apply)
- ACT
- Approach
- AutoCad
- Estimation (software)
- Goldmine
- MS Access
- MS Excel
- MS Office
- MS PowerPoint
- MS Word
- QuickPen
- SalesLogix
- WinSales
Certifications & Licenses
What Certifications & Licenses do you have?
(Select all that apply)
- Apprentice Plumber License
- ASPE - CPD (Certified in Plumbing Design)
- IAMPO Certified Inspector
- ICC Commercial Plumbing Inspector
- ICC Plumbing Code Official
- ICC Plumbing Inspector
- ICC Plumbing Plans Examiner
- ICC Residential Plumbing Inspector
- Journeyman Plumber License
- Master Plumber License
- NSF Certification
- Registered Professional Engineer
Include State and License Numbers for any licenses selected above, if applicable:
Other Licenses & Certifications held:
Additional Information
Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying. If you have a resume, please upload it at the end of this application.
Professional References

List 3-4 people you have worked with who can attest to your on-the-job experience and performance. Do not include relatives. (Click the + button to add a new row)*

Name	Position	Company	Telephone	Email Address

Did you complete this application yourself?*
- Yes
- No
If not, who did?
Agreement (please read carefully before signing)
I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that any misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.

I understand that neither the acceptance of this application, nor the subsequent entry into any type of employment relationship with Chris' Plumbing & Repair, INC., creates an actual or implied contract of employment. I understand that, if I accept employment with Chris' Plumbing & Repair, INC., it will be on an at-will basis. This means that either Chris' Plumbing & Repair, INC. or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.

I agree to submit to alcohol testing, if requested by Chris' Plumbing & Repair, INC. I release Chris' Plumbing & Repair, INC. and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing.

I authorize Chris' Plumbing & Repair, INC. to investigate information concerning my education, licensing, certifications, driving record, criminal history, employment experiences and all other aspects of my background relevant to my proposed employment. I release Chris' Plumbing & Repair, INC. and its employees from all liability arising from such investigation.

*Chris' Plumbing & Repair, INC. is an equal opportunity employer. We adhere to a policy of making decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Chris' Plumbing & Repair, INC. depends solely on your qualifications.
Digital Signature:

Printing your First Name + Middle Initial + Last Name will act as your digital signature.
Date
MM slash DD slash YYYY
Resume Upload (optional)
Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf, Max. file size: 496 MB.
If you have a resume you'd like to attach, please do so here. This is not required.
Would you like to add a cover letter?
- Yes
- No
Cover Letter (optional)
Max. file size: 496 MB.
Please upload your cover letter here. You may also copy and paste the contents of your cover letter in the space below.
Email
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Personal

Employment Information

Education

Criminal History

Driver's License Information

Military Service

Work Experience

Plumbing Industry Skills

Certifications & Licenses

Additional Information

Professional References

Agreement (please read carefully before signing)