Job Application

Lewis Roofing Job Application

personal Information

Last NameFirst Name & Middle InitialSSN#

EmailHome PhoneMobile Phone

Street Address

City

State

Zip Code

Are you entitled to work in the United States?Are you 18 or older?If yes, Date of Birth

Have you been convicted of a felony or been incarcerated in connection with a felony in the past seven years?If yes, please explain:

Military Service?Branch

Are you a veteran?War

What position are you applying for?Expected Hourly RateExpected Weekly Earnings

How did you hear about this position?Date Available

Prior Work Experience

Current or Most RecentEmployerAddressCity, ST, ZIPTelephoneName of Immediate SupervisorDates of EmploymentPosition / Job TitlePayReason for LeavingMay We Contact?

PriorEmployerAddressCity, ST, ZIPTelephoneName of Immediate SupervisorDates of EmploymentPosition / Job TitlePayReason for LeavingMay We Contact?

Education

High SchoolName / LocationLast Year CompleteDegreeMajor or Emphasis

College/UniversityName / LocationLast Year CompleteDegreeMajor or Emphasis

Trade SchoolName / LocationLast Year CompleteDegreeMajor or Emphasis

OtherName / LocationLast Year CompleteDegreeMajor or Emphasis

List any applicable special skills, training or proficiencies.

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