Careers | Massie Creek Plumbing

Personal Information

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How did you hear about our company?

Employment Information

Citizenship/ Work Status*

U.S. Citizen, Green Card Holder, U.S. Work Permit/Visa, Canadian Citizen, Canadian Work Permit/Visa

Current Employer

Contact Name & Contact Number

Years of Work Experience directly related to the plumbing field?

Employment Type Desired*

Full Time

Part Time

Desired Compensation

When are you available to start work?

Education

High School?

Name of School, Location, High School Diploma or GED?

College / University?

Name of School, Location, Major, Associates or Bachelor’s?

Trade School?

Name of School, Location, Major, Certificate?

Please check all certificates/licenses you currently have in the State of Ohio:

Apprentice Plumber License

Journeyman Plumber License

Master Plumber Contractor License

Backflow Prevention Certified Tester

Private Water Systems License

Criminal History

Have you ever been convicted of a felony or misdemeanor (except any minor traffic violation)?*

No

Yes

If Yes, please explain and attach any relevant documentation.

Driver's License

Do you have a valid Ohio Driver’s License?

Yes

No

Driver's License Number

State of Issue

Do you have reliable transportation to work?

Do you have a Commercial (CDL) license for the State of Ohio?

Yes

No

Do you have a clean driving record?

Yes

No

List any Moving Violations and/or Accidents from the last 3 years:

Work Experience

Employer #1

Name of Employer

Address of Employer

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer's Phone Number

Name of Supervisor / Owner

Job Title

Employment Dates (from - to)

Pay / Salary (Start - Final)

Specific reason for leaving

List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact this employer?

Yes

No

Employer #2

Name of Employer

Address of Employer

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer's Phone Number

Name of Supervisor / Owner

Job Title

Employment Dates (from - to)

Pay / Salary (Start - Final)

Specific reason for leaving

List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact this employer?

Yes

No

Professional References

Reference #1

Name, Position, Company, Phone, Email Address

Reference #2

Name, Position, Company, Phone, Email Address

Reference #3

Name, Position, Company, Phone, Email Address

Did you complete this application yourself?

Yes

No

If not, who did?

Agreement

Digital Signature*

Date*

Massie Creek Enterprises, LLC DBA Massie Creek Plumbing & Pump Service is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Massie Creek Enterprises, LLC DBA Massie Creek Plumbing & Pump Service depends solely on your qualifications.

Name

This field is for validation purposes and should be left unchanged.