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Employment Application: Field Personnel
EXPERIENCE Check all that apply:
1 ] What is the highest level of education you have completed?
2 ] List any additional experiences, skills and qualifications which you believe relate to the job(s) for which you are applying:
3 ] Do you currently hold a valid drivers license?
4 ] Do you currently have a valid CDL?
5 ] Are you over 18?
6 ] If previously employed by us, when and where:
7 ] List any friends or relatives that work for us:
8 ] Position(s) applying for:
9 ] Date available for work:
10 ] How did you learn about job (check one)?
11 ] Applying for:
12 ] Pay expected:
13 ] Are you able to travel?
14 ] Are you subject to any employment agreement or post-employment agreement with any other entity?
15 ] Can you perform the essential functions of the position for which you are applying with or without reasonable accommodation?(If you have any questions as to the essential functions of a specific role, please ask interviewer before answering.
16 ] Are you presently authorized to work in the United States?
17 ] Will you now or in the future require employer sponsorship in order to begin or continue working legally in the United States?
We do not sponsor individuals for the purpose of obtaining H-IB status or any other non-immigrant or immigrant status of visa. In compliance with the Immigration Reform and Control Act of 1986, it is the Company’s policy to hire and employ only workers authorized to work in the United States. All offers of employment are therefore contingent upon an applicant’s ability to properly complete a Form I-9, Employment Eligibility Verification Form within three (3) business days of his/her first day of work with the Company.
PAST EMPLOYERS List your last two employers, including military service, beginning with your most recent:
REFERENCES List two work-related references, including in military services, whom you have known at least one year:
Name, phone, address and business:
As required by the Fair Credit Reporting act, this is to advise you that, in connection with your application for employment with the Company, a consumer report, which may include information regarding your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living may be obtained with respect to you for employment purposes from a consumer reporting agency. The report may include checks of state and federal judicial and other public records, both criminal and civil and which may include verification of employment, compensation and professional references, Social Security information, education verification, and driving record in connection with your application for employment. I hereby fullyauthorize the Company, its employees and agents, including Sterling Information Systems ( 249 West 17th Street, 6th Floor, New York, NY 10011, 800-899-2272), to conduct any investigations into my background on behalf of the Company and for the above agencies and entitiesto release this information on my behalf.
Information concerning credit worthiness, credit standing or credit capacity will not be requested where prohibited by law. Such information may be requested for applicants applying for positions where satisfactory credit history is an occupational requirement of the position
A copy of your rights under the Fair Credit Reporting Act is attached.
I have carefully read the foregoing and fully understand its contents. I acknowledge that my signing of this authorization is voluntary.
California, Maine, Massachusetts or Minnesota Applicants: Check here if you want a copy of the consumer report requested by the Company. You also have the right to request a copy from the agency furnishing the report.
Maine Applicants: If you ask us, you have the right to know whether the Company ordered a background check report on you. You may request the name, address, and telephone number of the nearest office for the consumer reporting agency. We will send this information to you within five business days of our receipt of your request. You have the right to ask the consumer reporting agency for the report.
New York Applicants: You have the right, upon written request, to be told whether a report was requested and, if it was, the name and address of the agency which prepared it. Please note that if you are hired, subsequent consumer reports may be obtained in connection with employment.
Washington State Applicants: You have the right, upon written request made within a reasonable time frame after your receipt of this disclosure, to receive from the Company a complete and accurate disclosure of the nature and scope of any “investigative” consumer report we may have requested. You also have the right to request from the consumer reporting agency a written summary of your rights and remedies under the Washington Fair Credit Reporting Act. If the Company obtains information bearing on your credit worthiness, credit standing, or credit capacity, it will be used to evaluate whether you would present an unacceptable risk of theft or other dishonest behavior in the job for which you are being considered.


CENTRAL ROOFING COMPANY is an Equal Employment Opportunity Employer. The information asked of you is used to evaluate our overall efforts in reaching all segments of the population and in reviewing our selection and placement efforts. The following is VOLUNTARY and CONFIDENTIAL. This information is NOT A PART OF THE APPLICATION FILE and is removed from the application when received by our office. All additional information requested, if it relates to a disability, will be maintained as SEPARATE and CONFIDENTIAL medical records. CENTRAL ROOFING COMPANY would appreciate your cooperation in our efforts to ensure Affirmative Action and Equal Employment Opportunity when targets Women, Minority Groups (defined as persons of color), and the Disabled (differently able). You may benefit, as a Woman, a Minority or as Disabled person the Company's Expanded Certification Interviewing Program. Any false statement, which harms the Company's Affirmative Action and Equal Employment Opportunity Program, may be punished by law.
Please respond to the following prompts by checking the boxes that most accurately describe you. If opting out of providing this voluntary information, scroll to the bottom of the page to submit your application.
Disability (differently able) status, is defined as: 1) A person with a physical, sensory, or mental impairment (condition) which significantly limits one or more life activities; 2) has a record of such impairment; and 3) is regarded as having such impairment.
CENTRAL ROOFING COMPANY, will provide job accommodations for the Disabled on a case-by-case basis, by reviewing the essential functions of the position vacancy to determine what, if any, reasonable accommodations can be made.
This concludes the CENTRAL ROOFING COMPANY online job application. Please verify your contact information and responses are correct before clicking 'Submit.' We will contact you to schedule an interview when a position that fits your area of interest and experience is available. Thank you!

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