Employment Application

Are you a team player? Do you want to join a winning team?

Addicott Roofing, Inc. is accepting applications for Laborers, Yard Keepers and Job Foremen.

You must be able to work on your own, have a valid driver's license, and the ambition to grow with our company.

Take the Lid Off Your Future and come join our team!

Please Note: We will NEVER sell or rent your personal information to any third parties.

Employment Opportunities
First Name*
Last Name*
Contact Phone*
Email Address*
Street Address, City, State, Zip*
If employed can you provide proof of US Citizenship?*	Yes No
Are you 18 years of age or older?*	Yes No
Position applying for
Referred by
If employed, will you be able to work on projects throughout the State of Washington?	Yes No
Do you have a valid Washington State Drivers License?	Yes No
What is your Drivers License #?
Have you been convicted of a crime (other than traffic violations) or been imprisoned during the last 7 years? A conviction does no necessarily bar you from employment.	Yes No
If yes, please explain
Do you have any physical or mental disabilities that may limit your performance in the job you're applying for?
If yes, please explain
How did you hear about Addicott Roofing?*	Please Choose >> Yellow Pages Direct Mail Radio Ad Online Search Referral Other
Previous Employer 1
Dates of Employment
Contact Phone
Ending Salary
Supervisor's Name
Reason for leaving
Previous Employment 2
Dates of Employment
Contact Phone
Ending Salary
Supervisor's Name
Reason for leaving
Reference 1
Contact Phone
Relationship
Reference 2
Contact Phone
Relationship
Typing your full name in the following box constitutes your legal signature*
Today's Date*
Access Code
Please Enter the Access Code *
Fields Marked * are Required.

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name of the agency so I may obtain from them the nature and substance of the information contained in the report.