Service Technician Employment Application

Personal Information

EEO Statement – We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.

Name *

First

Middle

Last

Employment Authorization Statement – Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.

Email *

Phone *

Address *

Address Line 1

City

State

Zip Code

Position Applying For *

1. Is there any information we would need about your name or use of another name for us to be able to check your work record? Please specify: *

2. Do you have any relatives who are presently (or have formerly been) employed by this company? *

3. How were you referred to us? *

4. Have you ever been convicted of a felony? Yes or No If yes, please explain: *

Required Questions

Can you accurately read numbers and use a keyboard? *

Can you walk for long periods in any weather condition? *

Can you lift 100 lbs. occasionally, without assistance? *

Can you lift 50 lbs. regularly, without assistance? *

Do you have legible handwriting? *

Do you possess a high school diploma/GED? *

Do you possess a valid Arizona driver's license? *

Have you had your driving privileges suspended or revoked? *

Are you currently on "lay-off" status, subject to recall? *

Can you provide documentation showing your right to work in the USA? *

Have you read and understood the notes above? *

Are you currently employed? *

If currently employed, may we contact your present employer? *

Education Information – Please list School Name, Location, Years Completed, Degree/Diploma Earned

High School *

College *

Technical Training *

Other Training *

Skills and Qualifications – Please indicate the number that matches your proficiency (1 star=no experience, 5 stars=proficient)

Please describe your qualifications and any specialized training in the following areas

Customer Service

Maintenance

Machine Operations

Outdoor Work

Other Skills

Strengths

Why should we consider you for this position? *

Work History – Please list your last three jobs

Company #1 *

Position Held *

Address/City/State *

Dates Employed (From/To) *

Wages/Salary *

Manager/Supervisor *

Phone Number *

Email Address

Reason for Leaving *

Company #2 *

Position Held *

Address/City/State *

Dates Employed (From/To) *

Wages/Salary *

Manager/Supervisor *

Phone Number *

Email Address

Reason for Leaving *

Company #3 *

Position Held *

Address/City/State *

Dates Employed (From/To) *

Wages/Salary *

Manager/Supervisor *

Phone Number *

Email Address

Reason for Leaving *

References – Names and Phone Numbers (please do not include relatives or former employers)

Reference #1 *

Reference #2 *

Reference #3 *

Work Availability

Condition of Hire – Note 1: As a condition of hire, applicants must be 18 years of age or over. Note 2: As a condition of hire, applicant must pass a drug & alcohol screening, and physical examination. Note 3: As a condition of hire, applicant must possess excellent driving record and must maintain an excellent driving record as a condition of continued employment. Note 4: Community Water Company maintains a non-tobacco using environment. Note 5: As a condition of continued employment, Service Technicians must obtain an Arizona Department of Environmental Quality Grade 1 Water Distribution System Certificate within one year of hire and additional operator certification is encouraged.

Should your application receive favorable considerations, when are you available to begin work?

Can you work overtime if needed?

Name *

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statement contained in this application for employment that may be necessary in arriving an any employment decision. This application for employment shall be considered active for a limited period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. Applications will be retained in accordance with state law. I hereby understand and acknowledge that any employment relationship with this organization is of an “at will” nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of the organization. In the even of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by all rules and regulations of the employer.

Date *

Resume *

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