Would you agree to pre-employment and random drug testing?YesNo

Are you able to perform routine physical work involving heavy lifting? YesNo

Are you afraid of heights? YesNo

List all previous work experience, starting with your most recent.

Company 1

Company 2

Company 3

Did you receive your high school diploma or equivalent? YesNo

Do you plan to further your education? YesNo

Please list three references that have knowledge of your work history/ethic, who is not a friend or family member.

Name

Relationship

Phone Number

I certify that all information I have provided in order to apply for work with Woolbright's Roofing & Construction, Inc. is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to 1) eliminate me from further consideration for employment, or 2) may result in my immediate discharge from Woolbright's Roofing & Construction, Inc. whenever it is discovered.

If I am hired, I understand that I am to resign at any time, with or without cause and with or without prior notice, and Woolbright's Roofing & Construction, Inc. reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law.

No question on this application is used for limiting or excluding an applicant from consideration for employment based on his or her sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state or local law. Woolbright's Roofing & Construction, Inc. likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status.

I agree by typing my full name and the date below.

Full Name:

Application Date: