Employment Application

Thank you for your interest in Bill Russell Plumbing. We are always recruiting professionals to join us in serving our customers better. Please fill out the employment application below, and we will review your information.

We provide the following benefits for our technicians:

  • Top pay
  • Paid vacation
  • Family health insurance
  • Company provided uniforms and cleaning services
  • Retirement pension
  • Annuity fund
  • Drug free and sober workplace
  • Fully stocked truck with company provided tools

    • Personal Information
    Name (Last, First)
    		 Social Security No.
    - -
    Present Address
    		 City
    		 State
    		 Zip
    Permanent Address
    		 City
    		 State
    		 Zip
    Phone Number

    		 Referred By
    Are you 18 years of age or older? Yes No
    Employment Desired
    Position
    Date You Can Start
    		 Salary Desired
    Are you currently employed?
    Yes No    		 If so, may we inquire of your present employer?
    Yes No
    Have you applied to this company before?
    Yes No    		 If so, where and when?
    Education History
    Grammar School
    Name and Location
    Years Attended
    		 Did you graduate?
    Yes No
    Subjects Studied
    High School
    Name and Location
    Years Attended
    		 Did you graduate?
    Yes No
    Subjects Studied
    College
    Name and Location
    Years Attended
    		 Did you graduate?
    Yes No
    Subjects Studied
    Trade, Business or Correspondence School
    Name and Location
    Years Attended
    		 Did you graduate?
    Yes No
    Subjects Studied
    General Information
    Subjects of Special Study or Research Work
    Job Related Skills (typing, driver's license, etc.)
    Activities other than Religious (Civic, Athletic, etc.)
    U.S. Military or Naval Service
    		 Rank

    Former Employers (Last four employers, starting with last one first)
    Name and Address of Employer
    Starting Date
    		 Ending Date
    Ending Salary
    		 Position
    Reason For Leaving
    Name and Address of Employer
    Starting Date
    		 Ending Date
    Ending Salary
    		 Position
    Reason For Leaving
    Name and Address of Employer
    Starting Date
    		 Ending Date
    Ending Salary
    		 Position
    Reason For Leaving
    Name and Address of Employer
    Starting Date
    		 Ending Date
    Ending Salary
    		 Position
    Reason For Leaving
    References
    Name
    		 Business
    Address
    		 Years Known
    Name
    		 Business
    Address
    		 Years Known
    Name
    		 Business
    Address
    		 Years Known
    Name
    		 Business
    Address
    		 Years Known
    Licences
    Plumbing
    		 Mechanical
    Other (Please List)
    Authorization (Please read and then type your name below)

    “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

    I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

    I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

    This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

    By typing your name and date below you are agreeing to this authorization.
    Signature
    		 Date