Baker Home Preservation LLC Logo
 
Building Contractor CBC 1260840
Roofing Contractor CCC 1331017
 
CALL US TODAY
Dade City, FL 33525
info@bhpcontracting.com
 
 
 
 
 
 

Application for Employment

 

 
 

 
Employment Positions: General Technician, Supervisor, and Xactimate Estimating/Sales

Baker Home Preservation LLC is an Equal Employment Opportunity Employer which makes employment decisions without regard to race, color, sex, religion, national origin, disability, marital status and all other characteristics protected by law. The Company also reasonably accommodates individuals with handicaps, disabilities and bona fide religious beliefs.
 
Baker Home Preservation LLC is a Drug-Free Workplace.
(PLEASE COMPLETELY ANSWER ALL QUESTIONS. FAILURE TO COMPLETELY ANSWER ALL QUESITONS MAY RESULT IN DISQUALIFICATION FROM EMPLOYMENT)
 
 
POSITION APPLIED FOR:
 
 
 
 
DATE:
 
 
 

 
Last Name
 
First
 
Middle
 
Social Security Number
 
 
Street Address
 
City
 
State/Zip Code
 
Telephone No
 
 
 
Are you at least 18 years old?
 
 
 
 
 
 
 
 
 
 
 
If not, state your age for child labor law purposes only
 
 
 
 
 
Are there any days, shifts or hours you will not work?
 
 
 
 
 
 
 
 
 
 
 
If yes, please list the times you will not work
 
 
 
 
Are you available to work out of town?
 
 
 
 
 
 
 
 
 
 
Will you work overtime, if required?
 
 
 
 
 
 
 
 
 
 
When will you be able to start work?
 
 
 
 
Have you ever been convicted of any crime?
 
 
 
 
 
 
 
 
 
 
(A conviction will not necessarily disqualify you). If yes, please provide details of the type of crime, the date of the conviction, and penalty imposed.
 
 
 
Can you, within three business days after employment, submit documents verifying that you are legally eligible to work in the United States?
 
 
 
 
 
 
 
 
 
 
Have you taken any illegal drugs in the last 30 days?
 
 
 
 
 
 
 
 
 
 
How did you learn of our Company?
 
 
 
 
Have you ever applied or worked here before?
 
 
 
 
 
 
 
 
 
 
 
If yes, provide dates:
 
 
 
 
List any relatives or friends currently employed here:
 
 
EMPLOYMENT HISTORY (Please complete for all full-time or part-time employment beginning with most recent employer)
 
 
Company Name
 
 
 
 
Tel #
 
 
 
 
 
Address
 
 
 
Dates Employed
 
 
From:
 
 
 
 
To
 
 
 
 
 
 
Name of Supervisor
 
 
 
 
Weekly/hourly Pay:
 
 
 
 
 
State job titles and describe job duties:
 
 
 
 
Reason(s) for leaving:
 
 
 

 
 
Company Name
 
 
 
 
Tel #
 
 
 
 
 
Address
 
 
 
Dates Employed
 
 
From:
 
 
 
 
To
 
 
 
 
 
 
Name of Supervisor
 
 
 
 
Weekly/hourly Pay:
 
 
 
 
 
State job titles and describe job duties:
 
 
 
 
Reason(s) for leaving:
 
 
 

 
 
Company Name
 
 
 
 
Tel #
 
 
 
 
 
Address
 
 
 
Dates Employed
 
 
From:
 
 
 
 
To
 
 
 
 
 
 
Name of Supervisor
 
 
 
 
Weekly/hourly Pay:
 
 
 
 
 
State job titles and describe job duties:
 
 
 
 
Reason(s) for leaving:
 
 
 

 
 
Company Name
 
 
 
 
Tel #
 
 
 
 
 
Address
 
 
 
Dates Employed
 
 
From:
 
 
 
 
To
 
 
 
 
 
 
Name of Supervisor
 
 
 
 
Weekly/hourly Pay:
 
 
 
 
 
State job titles and describe job duties:
 
 
 
 
Reason(s) for leaving:
 
 
 
 
Please explain any gaps in your employment history
 
 
 
Have you ever been discharged or asked to resign?
 
 
 
 
 
 
 
 
 
 
If yes, explain:
 
 
 
Were you given a performance evaluation within the last 12 months of active employment?
 
 
 
 
 
 
 
 
 
 
If yes, what was the range of scores used and what was your score?
 
 
 
 
Have you signed any non-compete agreement with any other employer that would restrict you from working with this company?
 
 
 
 
 
 
 
 
 
 
If yes, please explain
 
 

MILITARY (complete only if you served in the military)
 
 
Branch of Service
 
 
 
 
Dates of Service:
 
 
 
From:
 
 
 
 
To
 
 
 
 
 
 
 
Rank at Discharge:
 
 
 
 
Date at discharge:
 
 
 
 
Were you honorably discharged?
 
 
 
 
 
 
 
 
 
Describe any military skill, training or experience you believe are relevant to the job applied for:

EDUCATION
Describe any educational degrees, skills, training or experience you believe are relevant to the job applied
 
For:
 
 
DRIVING RECORD: (May or may not be considered depending on job applied for)
 
Do you have a valid drivers license?
 
 
 
 
 
 
 
 
 
 
License No.
 
 
 
 
Have you had any tickets?
 
 
 
 
 
 
 
 
 
 
 
If yes, explain:
 
 
 
 
 
Has your license ever been suspended or revoked?
 
 
 
 
 
 
 
 
 
 
 
If yes, explain:
 
 
 

 
 
Do you have any DUI or DWI convictions?
 
 
 
 
 
 
 
 
 
 
 
If yes, explain:
 
 
 
 
Do you have a reliable form of transportation to work?
 
 
 
 
 
 
 
 
 
APPLICANT’S ACKNOWLEDGMENT
I certify that the answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts or incomplete answers in any application document will disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts in any application document will be cause for my dismissal at any time without prior notice.
I understand that, if employed, my employment with the Employer is not for a specific term and may be terminated by me or the Employer with or without notice or cause at any time. I further understand that no oral promise, Employer policy, custom, business practice or other procedure constitute an employment contract for a definite duration or modification of the at-will employment relationship between me and the Employer.
I understand that any employment offer may be contingent upon providing appropriate medical information including, but not limited to, successfully completing a pre-employment medical examination and a drug test.
I acknowledge that this application will remain active for 90 days from this date. If I have not heard from the Company at the conclusion of this 90 day period, it is my responsibility to complete a new application if I still wish to be considered for employment by the Company.
 
Signature:
 
 
 
 
 
Date:
 
 
 
 
Upload a Resume:
 
 
 
 
Applicant may also email a resume to info@bhpcontracting.com
Once completed this form will be sent to info@bhpcontracting.com for review.
Or you may print out the Employment Application. And either mail to PO Box 7271 Welsey Chapel FL 33545 or scan and email to info@bhpcontracting.com.