Employment Application

Perkins Home & Building Center is an Equal Opportunity Employer and is committed to excellence through diversity.

The online application for employment must be fully completed to be considered. Please add your resume and electronically sign the application before submitting.

Personal Information

First Name

Last Name

Address

City

Phone Number

State

Zip

Mobile Number

Are You A U.S. Citizen?

Yes

Have You Ever Been Convicted of A Felony?

Yes

Are You Willing To Submit to a Pre-Employment Drug Scrreening Test?

Yes

Position

Available Start Date

Desired Pay

Employment Desired

Full Time

Part Time

Seasonal/Temporary

Education

School Name 1

School Location 1

Years Attended 1

Degree Received 1

Major 1

School Name 2

School Location 2

Years Attended 2

Degree Received 2

Major 2

School Name 3

School Location 3

Years Attended 3

Degree Received 3

Major 3

School Name 4

School Location 4

Years Attended 4

Degree Received 4

Major 4

References

Reference Name 1

Reference Company 1

Reference Title 1

Reference Phone 1

Reference Name 2

Reference Company 2

Reference Title 2

Reference Phone 2

Reference Name 3

Reference Company 3

Reference Title 3

Reference Phone 3

Reference Name 4

Reference Company 4

Reference Title 4

Reference Phone 4

Employment History

Employer (1)

Dates Employed

Starting Pay Rate

Job Title

Work Phone

Ending Pay Rate

Employer Address (1)

Employer (2)

Dates Employed

Starting Pay Rate

Job Title

Work Phone

Ending Pay Rate

Employer Address (2)

Employer (3)

Dates Employed

Starting Pay Rate

Job Title

Work Phone

Ending Pay Rate

Employer Address (3)

Employer (4)

Dates Employed

Starting Pay Rate

Job Title

Work Phone

Ending Pay Rate

Employer Address (4)

Employer (5)

Dates Employed

Starting Pay Rate

Job Title

Work Phone

Ending Pay Rate

Employer Address (5)

Signature Disclaimer

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Your Signature

Name

Date

Upload Resume

Thanks for submitting your application!