Employment Application | Careers | Chesapeake Home Services

Name*

First Name* Last Name*

Address*

Address* City* Zip Code*

Phone Number*

Alternate Phone Number

Email Address

Work Experience – List Most Recent Job First

From*

To*

Employer's Name*

Employer's Address*

Employer's Phone*

Job Title*

Reason for Leaving*

Describe the work you did*

Add Second Job

Add Second Job

From

To

Employer's Name

Employer's Address

Employer's Phone

Job Title

Reason for Leaving

Describe the work you did

Add Third Job

Add Third Job

From

To

Employer's Name

Employer's Address

Employer's Phone

Job Title

Reason for Leaving

Describe the work you did

General Information

What position are you applying for?*

When are you available to start work?*

Full Time/Part Time*

Full Time
Part Time

Are you willing to work overtime?*

Yes
No

Are you at least 18 years old?*

Yes
No

If not, can you provide a valid Work Permit, high school diploma, or equivalent?*

Yes
No

What languages do you speak, read, or write fluently?*

If hired, can you verify that you have the legal right to work in the United States?*

Yes
No

Do you have any special skills, training or experience which may help you quality for this job?*

Yes
No

If so, please explain.

Do any of your relatives work this company?*

Yes
No

If so, who?*

Have you ever worked for this company before?*

Yes
No

If so, when?*

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses? NOTE: Conviction will not disqualify applicant.*

Yes
No

If so, please explain.*

How did you find out about this job? If by an employee, who?*

Certification and Acknowledgement

I certify that the information I provided herein is true and correct to the best of my knowledge. I understand that, if employed, falsified statements on this application for employment form will be considered grounds for termination.*

I authorize the company to thoroughly investigate my work experience and any other matters related to my suitability for employment. I further authorize my former employer to disclose to the company any and all information they may have concerning my previous employment. In addition, I hereby release the company, my former employers and all other persons from any and all claims, demands, or liabilities arising out of, or in any way related to, such disclosure.*

I acknowledge that, if employed, both the company and i have the right to terminate the employment relationship at any time, with or without cause or advance notice. This employment at will relationship will remain in effect throughout my employment with the company and may not be modified by any oral or implied agreement.*

*

Cover Letter & Resume

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Accepted file types: pdf, doc, docx, Max. file size: 2 MB, Max. files: 2.

Employment Application Online Form

Work Experience – List Most Recent Job First

General Information

Certification and Acknowledgement