Stockett Tile & Granite Company
APPLICATION FOR EMPLOYMENT
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To Applicant: It is our policy to provide equal employment opportunities to all qualified persons, without regard to race, age,
color, sex, religion, national origin, or handicap.
PLEASE PRINT or TYPE CLEARLY
Date: _____________________
Name: _______________________________________________________________________________________
First
Middle
Last
Address: _____________________________________________________________________________________
Street
City
Home Phone: _________________________
State
Zip Code
Mobile Phone: ____________________________________
Position applying for: __________________________________________ Wage Desired: _________________
How did you learn about our company? _________________________________________________________
Are you legally eligible to work in the United States? _________________
Have you ever been employed with us before? Yes: _____ No: _____ If yes, give date: _______________
Are you currently employed? _________ Are you willing to work overtime? _________________________
On what date would you be available for work? _________________________
Are you available to work: Full Time____________ First shift __________ Second shift ________________
Are you age 18 or older? Yes: _______ No: _______
Do you have a current valid driver's license? ______ License #/State _________________________________
Do you have adequate transportation? _______
Have you ever been convicted of a felony or a crime within the last 7 years? _________________________
If yes, please explain___________________________________________________________________________
Specialized Skills/Tools (tile, fabrication, finishing, marble/stone experience, any tools you can use, etc.):
______________________________________________________________________________________________
_______________________________________________________________________________________________
______________________________________________________________________________________________
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EDUCATION:
Highest grade completed? ______
Did you receive a high school diploma/GED? Yes__ No__
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REFERENCES: Must be a previous supervisor/employer/instructor; NO PERSONAL REFERENCES
Name: ___________________________________________________
Phone #: ________________________
Name: ___________________________________________________
Phone #: ________________________
Name: ___________________________________________________
Phone #: __________________________
EMPLOYMENT HISTORY:
List below your last three employers, starting with your present or last place of employment. Do not write
“See Resume”. If you have a resume you may attach it in addition to completing this section.
If you are presently employed, may we contact your present employer? Yes _____
From ________ _________________________________
Date/Yr
To _______
Date/Yr
Employer Name
________________________________
No _____
__________
_____________________________
Hourly Wage
Position
Type of employment :____________________________
Employer Address
Full time, Part-time, Temp.
Employer Phone: _______________________________
Supervisor: ________________________________
Reason for leaving: ______________________________________________________________________________
Duties: _________________________________________________________________________________________
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From ________ _________________________________
__________
_____________________________
Date/Yr
To _______
Date/Yr
Employer Name
________________________________
Hourly Wage
Position
Type of employment :____________________________
Employer Address
Full time, Part-time, Temp.
Employer Phone: _______________________________
Supervisor: _________________________________
Reason for leaving: _______________________________________________________________________________
Duties: _________________________________________________________________________________________
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From ________ _________________________________
__________
_____________________________
Date/Yr
To _______
Date/Yr
Employer Name
________________________________
Hourly Wage
Position
Type of employment :____________________________
Employer Address
Employer Phone: _______________________________
Full time, Part-time, Temp.
Supervisor: ________________________________
Reason for leaving: _______________________________________________________________________________
Duties: _________________________________________________________________________________________
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In signing this application, I certify that answers given herein are true and complete to the best of my knowledge. I
hereby authorize Stockett Tile & Granite Company to conduct any investigation necessary concerning any part of my
background related to the position I am seeking. I release all parties from any liability in connection with the provision and
use of such information.
I understand that employment with Stockett Tile & Granite Company, if offered, is contingent upon my fulfilling
the requirements of the Immigration Reform and Control Act.
I understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with
this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may
discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship
may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by
the President of Stockett Tile & Granite Company.
In the event of employment, I understand that false or misleading information given in my application or
interview(s) may result in discharge. I understand, also, that I am required to abide by the rules of regulations of the
employer, especially those to be found in the employee manual provided at the time of hire, which may be changed, with or
without notice.
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Applicant's Signature
____________________________
Date