Office Application and Assessment

• If hired, are you legally eligible to work in the United States?

  Yes No

• If necessary, can you provide proof that you are over the minimum work age requirement?

  Yes No

• Have you ever been terminated or asked to resign from any job? If yes, give details.

  Yes No
• Details of termination or resignation

• Have you ever been convicted of, received sentence for, pled nolo contendere (no contest) to, been placed on probation, or fined by any judicial or quasi-judicial body for a crime other than a minor traffic violation? (Arrest records and juvenile, se

  Yes No
• Details

• Have you ever been a defendant in a civil action for an intentional tort (such as assault, battery, false imprisonment, invasion of privacy, infliction of emotional distress, wrongful death?) If yes, please give date and an explanation including loca

  Yes No
• Details *Conviction record will not necessarily prohibit employment.

EMPLOYMENT DESIRED

• Position Applying For
• Minimum pay rate desired
• Date available to start
• How did you learn about our company and/or position? If employee referral, specify name:

• Are there any days or hours you would be unable or unwilling to work?

  Yes No
• If yes, when?

• Will you be able to work overtime?

  Yes No

• Will you be able to travel within Florida?

  Yes No

• Have you applied with our company before?

  Yes No
• If yes, when?

• Have you been employed by Modern Plumbing Industries?

  Yes No
• If yes, when?

• Are you currently subject to a Non-Compete Agreement or Restrictive Covenant that would prohibit you from working at our company in the position for which you are applying?

  Yes No
• If yes, state the name of the company
• If yes, provide a copy of the agreement

High School

• High School Name
• City/State

• Graduated

  Yes No

• GED

  Yes No
• Course of study

College

• College Name
• City/State
• Years complete (select one)01234
• Course of study

Graduate School

• College Name
• City/State
• Years complete (select one)01234
• Course of study

• Are you planning to pursue further studies?

  Yes No
• If yes, when, where and what courses?
• List any scholastic honors, offices held and activities involved in during school:
• List and describe additional specialized training:
• Professional License
• Certification

DRIVING INFORMATION

• Will you be able to report to work on time and on a consistent basis?

  Yes No
• If no, explain

• Do you have a valid driver's license in Florida?

  Yes No
• If no, explain: valid driver's license

• Do you hold a valid and unexpired Drivers License that is not currently suspended or revoked? (Include professional and/or motor vehicle)

  Yes No
• Driver's license State
• Driver's license Type

• Have you ever had any license or certification suspended or revoked?

  Yes No
• If yes, state the specific reason(s) for the suspension(s) and/or revocation(s) and the date(s): explain:

Employer #1

• Employer
• Job position
• Address
• Telephone #
• Supervisor's Name

• Duties
• What did you like most about your job?
• What did you like least about your job?
• Reason for leaving

• Eligible for Re-hire?

  Yes No

Employer #2

• Employer
• Job position
• Address
• Telephone #
• Supervisor's Name

• Duties
• What did you like most about your job?
• What did you like least about your job?
• Reason for leaving

• Eligible for Re-hire?

  Yes No

Employer #3

• Employer
• Job position
• Address
• Telephone #
• Supervisor's Name

• Duties
• What did you like most about your job?
• What did you like least about your job?
• Reason for leaving

• Eligible for Re-hire?

  Yes No

• Are you presently employed?

  Yes No

• Have you ever been disciplined, demoted, suspended, placed on probation, or terminated from any job for an act of violence, harassment, discrimination, ethical breach, or theft?

  Yes No
• If yes, explain

• Other programs that you are skilled in?
• List any skills and abilities you have that relate to the position for which you are applying:

General

• Copying/Printing/Fax Scan

  No experience Some experience Good experience Extensive experience

• Wide Format Plotters/Scanner

  No experience Some experience Good experience Extensive experience

• Internet Research

  No experience Some experience Good experience Extensive experience

• Online Banking/Transactions

  No experience Some experience Good experience Extensive experience

• Credit Card Payment Processing

  No experience Some experience Good experience Extensive experience

• Notary Public

  No experience Some experience Good experience Extensive experience

• Mail Machines

  No experience Some experience Good experience Extensive experience

Data Entry

• Typing

  No experience Some experience Good experience Extensive experience

• 10-Key Calculator

  No experience Some experience Good experience Extensive experience

Software

• Word

  No experience Some experience Good experience Extensive experience

• Excel

  No experience Some experience Good experience Extensive experience

• Publisher

  No experience Some experience Good experience Extensive experience

• Windows

  No experience Some experience Good experience Extensive experience

• PowerPoint

  No experience Some experience Good experience Extensive experience

• Visio

  No experience Some experience Good experience Extensive experience

• Project

  No experience Some experience Good experience Extensive experience

• ComputerEase

  No experience Some experience Good experience Extensive experience

• Adobe Acrobat

  No experience Some experience Good experience Extensive experience

• Adobe Designer

  No experience Some experience Good experience Extensive experience

Estimation/Logistics

• Digitizer

  No experience Some experience Good experience Extensive experience

• Onscreen Takeoff

  No experience Some experience Good experience Extensive experience

• Auto CAD

  No experience Some experience Good experience Extensive experience

• Quickpen Pipe Designer

  No experience Some experience Good experience Extensive experience

• Navis/Works Manager

  No experience Some experience Good experience Extensive experience

• Small Tool Tracking

  No experience Some experience Good experience Extensive experience

• Estimating Pricing Service

  No experience Some experience Good experience Extensive experience

• Estimating Pricing Service Name

  No experience Some experience Good experience Extensive experience

• Digitizer Onscreen Takeoff

  No experience Some experience Good experience Extensive experience

• Wordpress

  No experience Some experience Good experience Extensive experience

• FTP Sites

  No experience Some experience Good experience Extensive experience

Applicant's Statement

I understand that if my application is accepted for consideration of employment, I authorize an investigation of all statements and information. In connection with my application for employment, I understand that results of the investigation background inquiries and personal information may be released to Modern Plumbing Industries as part of contract obligations. I also release any and all persons, companies, or agencies responding to such investigation from any liability for any damage due to releasing information.
The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information on this application (even if discovered after employment) or any other employment form may lead to dismissal or denial of employment.
In consideration of my employment, I agree to comply with the rules and regulations of Modern Plumbing Industries and my employment can be terminated for any reason and without notice, at any time, at the option of either the company or myself. I further understand that no oral promise, policy, business practice or other procedure, including any handbooks or manuals, constitutes an employment contract or modification of the at-will employment relationship between myself and Modern Plumbing Industries.
I understand that no supervisor or other official of Modern Plumbing Industries (except its President) has the authority to enter into an agreement with me or to make any agreement contrary to foregoing.
Applications (via internet, email, fax, mail, or submitted in person) will remain active for thirty (30) days. Any applicant requesting employment consideration beyond thirty (30) days must reapply.
I understand MPI reserves the right to request pre-employment, post accident, random or reasonable suspicion drug screening.
I HAVE READ, UNDERSTAND, AND BY MY SIGNATURE CONSENT TO THESE STATEMENTS.

• Digital Signature
• Date