APPLICATIONS MUST BE FILLED OUT ENTIRELY AND SUBMITTED IN A SINGLE SESSION. INCOMPLETE APPLICATIONS WILL NOT BE SAVED FOR YOUR COMPLETION AT A LATER DATE.

Worry Free Restoration is an equal opportunity employer. Please contact us if you require accomodation for the application or interiew.

APPLICANT INFORMATION

Position:

Full Name:

How were you referred to us?

Address:

Phone 1: Phone 2: Email:

Date available to start:

Social Security Number:

Salary Requirements:

If you are under 18 years of age, can you provide a work permit?

Yes No

If no, please explain:

Have you ever worked for this company before?

Yes No

If yes, when?

Are you legally allowed to work in the United States? (You will be required to provide, within 72 hours of hire, Employment Eligibility Verification Documents per Immigration Requirements.) Yes No

Type of employment desired: Full-time Part-time Temporary Seasonal

Have you been convicted of a felony in the past 7 years? (A conviction record will not necessarily be a bar to employment)

Yes No

If yes, please explain:

ANSWERING YES TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC REJECTION FOR EMPLOYMENT. DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND POSITION APPLIED FOR WILL BE CONSIDERED.

Driver's license number (if you have one, otherwise leave blank): State:

Commerical driver's license (if you have one, otherwise leave blank): Class: Endorsements:

EDUCATION HISTORY

Name and Location of High School:

Did you Graduate? Yes No

Name and Location of College:

Years attended:

Degree(s) completed:

Other subjects studied:

Trade, Business or Correspondence School:

Years attended:

Subjects Studied:

Did you Graduate? Yes No

SUMMARIZE YOUR SPECIAL SKILLS/ QUALIFICATIONS

CERTIFICATIONS and/or LICENSES pertinent to position for which you are applying:

(Include TITLE, STATE OR LICENSING AGENCY, and EXPIRATION DATE)

Rate your proficiency with Microsoft Word: None Beginning Intermediate Advanced

Rate your proficiency with Microsoft Excel: None Beginning Intermediate Advanced

Rate your proficiency with Microsoft Access: None Beginning Intermediate Advanced

Rate your proficiency with Microsoft Publisher: None Beginning Intermediate Advanced

Other computer software/programs you have experience with:

Typing speed: words per minute

10 Key by touch? Yes No

Cash handling experience? Yes No

List types of office equipment you can operate:

DESCRIBE YOUR EQUIPMENT OPERATION EXPERIENCE (pertaining to position for which you are applying)

Heavy/Light Equipment Types: Power Tools: Hand Tools:

PREVIOUS EMPLOYMENT

Begin with your present or most recent job.  List all jobs separately including on-the-job training, volunteer work and military experience.  Please be sure you describe completely in the sections below the duties performed, which demonstrate that you have the knowledge and skills to perform the duties of the job for which you are applying.  If in doubt about listing a particular job, it may be to your advantage to list it.  Incomplete applications will disqualify the applicant.  Worry Free Alaska LLC. will conduct background checks to verify information on applications.

Dates of employment: From: To:

Position(s) Held:

Company Name and Address:

Supervisor's Name & Title: Phone:

Responsibilities:

Starting Salary & Title:

Ending Salary & Title:

Reason for leaving:

May we contact your employer for a reference? Yes No

Dates of Employment: From: To:

Position(s) Held:

Company name and address:

Supervisor's Name & Title: Phone:

Responsibilities

Starting Salary & Title: Ending Salary & Title:

Reason for leaving:

May we contact your employer for a reference? Yes No

Dates of employment: From: To:

Position(s) Held:

Company Name and Address:

Supervisor's Name & Title:

Phone:

Responsibilities:

Starting Salary & Title:

Ending Salary & Title:

Reason for leaving:

May we contact your employer for a reference? Yes No

List three professional references (if different from employers previously listed):

(Include NAME, TITLE, COMPANY, ADDRESS, and PHONE #)

Worry Free Alaska LLC is subject to the Alaska Public Records Act, AS 09.25.110.  Your application for employment, and other documents concerning you, may be subject to public disclosure under state law.

I certify that all information provided in this application and any attachments is true.  I understand any false statement made herein is sufficient reason for rejection of my application or termination of subsequent employment.

I authorize Worry Free Alaska LLC, or entities it may employ, to investigate all statements made in this application or attachments; to contact any of my former employers, educational institutions, or any other person or organization that may have information relevant to my employment; to obtain records concerning my past work, character, education, or military background; to obtain a “consumer report” and/or “investigative consumer report” as defined by the Fair Credit Reporting act; to obtain driving records; to obtain any records pertaining to prior felony or misdemeanor convictions or pending felony or misdemeanor charges.  I authorize that such contact or investigation may occur at any time before or during employment.  I understand that I may be required to sign separate consent forms for this purpose.

I understand that no offer of salary or benefits is final until approved by the operational manager.

Electronic Signature of Applicant (application will be rejected without signature):

Date of submission: