Employment Application

HEROMAN SERVICES
PLANT COMPANY, LLC

753 Lakeside Dr.
Mobile, AL 36693
Phone: 251.607.6787
Fax: 888.293.4664
440 E. Heinberg St
Pensacola, FL 32502
850.936.6969
888.293.4664
505 Mountain St # H
Destin, FL 32541
850.424.3900
888.293.4664

Employment Application

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.

Date

I. Personal Information

Name: Last First Middle
Present Address
Permanent Address (if different than above)
Social Security Number Home Telephone
E-Mail Address Cell Phone Number

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of
employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of
being hired. Failure to submit such proof within the required time shall result in immediate employment termination.

Position Applied For:
HSPC location applied for: 
If Other, Please Provide:
  1. Is there any information we would need about your name or use of another name for us to be able to check your work record? Please specify:
  2. Do you have any relatives who are presently (or have formerly been) employed by Heroman Services Plant Company, LLC?
  3. How were you referred to Heroman Services Plant Company, LLC?
  4. Have you ever been convicted of a felony?       If yes, please explain:
  5. Why are you interested in working for HSPC?

II. Educational History

School Name/Location Years Completed Degree/Diploma
Elem/Jr. High
High School
College
Tech. Training
Other

III. Employment Record   Please include all employment for the last five years.

1. Company Name (Current or Most Recent Employer) Position Held
Address
Dates Employed: From To
Manager / Supervisor
Telephone Wage/Salary
Reason For Leaving
2. Company Name Position Held
Address
Dates Employed: From To
Manager / Supervisor
Telephone Wage/Salary
Reason For Leaving
3. Company Name Position Held
Address
Dates Employed: From To
Manager / Supervisor
Telephone Wage/Salary
Reason For Leaving

NOTE: We will contact all of the employers listed on this application unless you specifically exclude them below. Please list any employers you do not want us to contact and your reason for the exclusion:

(Employer’s Name) Reason
(Employer’s Name) Reason

IV. Other Experience and Skills   Please list all that may be relevant to the position you are applying for:

V. References   Please do not include relatives or former employers.

1. Name Years Known
Address Telephone
Occupation
2. Name Years Known
Address Telephone
Occupation
3. Name Years Known
Address Telephone
Occupation

VI. Work Availability

1. If your application receives favorable consideration, when will you be available to begin work?
2. Do you have any objection to working overtime?
3. Can you work overtime without prior notice?
4. Can you work on Saturday?
5. Can you work on Sunday?
6. Can you travel if required by this position?

VII. Salary / Hourly Rate Requirements

If your application receives favorable consideration, what salary/hourly rate would you require? This information MUST be included for job consideration.

$ per

The information provided in this Application for Employment is true, correct and complete. If you employ me, any misstatement or omission of fact on this application may result in my dismissal.

 

I understand that acceptance of an offer of employment creates no obligation upon you, the employer, to continue to employ me in the future.

Date Signature

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