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APPLICATION FOR EMPLOYMENT
We are an equal opportunity employer and do not unlawfully discriminate against any applicant because of race, color, religion, creed, sex, national origin, ancestry, citizenship status, marital status, qualified veteran’s status, genetic condition or information, age, qualified physical or mental disability, sexual orientation, gender identity or expression or any other class protected by federal, state or local law. Applicants should advise Human Resources if they require an accommodation of a disability to participate in the application process.
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Please complete in its entirety. (click to move from one field to the next) Date: Click here to enter a date.
Personal Information
Last Name: Click or tap here to enter text. First Name: Click or tap here to enter text. Middle: Click or tap here to enter text.
Present Address:
Street: Click or tap here to enter text. City: Click or tap here to enter text. State: Click or tap here to enter text. Zip Code: Click or tap here to enter text.
Mobile Number: Click or tap here to enter text. email: Click or tap here to enter text.
If hired, are you able to submit proof that you are legally eligible for employment in the U.S.? ☐Yes ☐No
Are you 18 years or older? ☐Yes ☐No
Proof of work authorization, required for I-9 purposes, must be produced within 72 hours of the start of employment.
Employment Desired
Position(s) applied for: Click or tap here to enter text.
Salary desired: Click or tap here to enter text.
Are you employed now? ☐Yes ☐No
If so, may we inquire of your present employer? ☐Yes ☐No
Have you ever filed an application with HydroWorx before?
☐ Yes ☐No
If so, when? Click or tap here to enter text.
Have you ever been employed by HydroWorx before? ☐Yes ☐No
If so, when? Click or tap here to enter text. What position? Click or tap here to enter text.
Are you applying to work: ☐ Full-Time ☐ Part-Time
☐ Temporary
☐ Days ☐ Evenings
Dates available for work: Click or tap here to enter text.
Total hours available: Click or tap here to enter text.
Will you work overtime if necessary? ☐Yes ☐No
If yes, how many hours per week? Click or tap here to enter text.
Education
| High School | Trade or Technical School | College | Graduate School or Prof. Courses | |
| Name of School | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| City and State | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| # of Years Completed | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| Course of Study/Major | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| Degree attained?
If yes, please indicate type; if no, please indicate No or Not Applicable, as appropriate |
Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| Honors Received | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
Please indicate any skills you have that may be relevant to the position for which you are applying:
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Describe any specialized study, job training, apprenticeships, or extracurricular activities:
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Experience
Military Service
Branch: Click or tap here to enter text. Rank: Click or tap here to enter text.
Discharge Date: Click or tap here to enter text.
Work Experience
Starting with your present or most recent employment, list all employment for the past 5-10 years, including self-employment, summer, part-time, and part or full-time military service (use back of form if necessary). You may also include any verifiable work performed on a volunteer basis.
| Employer | Click or tap here to enter text. | Dates of Employment | Work Performed | |
| City & State | Click or tap here to enter text. | From (Mo/Yr) | To
(Mo/Yr) |
Click or tap here to enter text. |
| Telephone | Click or tap here to enter text. | Click here to enter a date. | Click here to enter a date. | Click or tap here to enter text. |
| Job Title(s) | Click or tap here to enter text. |
Reason for Leaving |
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| Supervisor(s) | Click or tap here to enter text. | Click or tap here to enter text. | ||
| Employer | Click or tap here to enter text. | Dates of Employment | Work Performed | |
| City & State | Click or tap here to enter text. | From (Mo/Yr) | To
(Mo/Yr) |
Click or tap here to enter text. |
| Telephone | Click or tap here to enter text. | Click here to enter a date. | Click here to enter a date. | Click or tap here to enter text. |
| Job Title(s) | Click or tap here to enter text. |
Reason for Leaving |
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| Supervisor(s) | Click or tap here to enter text. | Click or tap here to enter text. | ||
| Employer | Click or tap here to enter text. | Dates of Employment | Work Performed | |
| City & State | Click or tap here to enter text. | From (Mo/Yr) | To
(Mo/Yr) |
Click or tap here to enter text. |
| Telephone | Click or tap here to enter text. | Click here to enter a date. | Click or tap here to enter text. | Click or tap here to enter text. |
| Job Title(s) | Click or tap here to enter text. |
Reason for Leaving |
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| Supervisor(s) | Click or tap here to enter text. | Click or tap here to enter text. | ||
Have you ever been involuntarily terminated or asked to resign your employment?
Yes ☐ No ☐
If yes, please identify the employer and explain the circumstances, either in the corresponding space below.
Click or tap here to enter text.
Did you sign any agreements with your current or former employers that impose any restrictions on your work for others, including, but not limited to, agreements regarding confidentiality, non-disclosure, non-solicitation of customers or employees, or non-compete agreements?
If yes, you must submit a copy of all agreements.
Yes ☐ No ☐
References
Give the names of three persons not related to you, whom you have known for at least one year that are professional references.
| NAME | ADDRESS | RELATIONSHIP | YEARS KNOWN | PHONE |
| Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
| Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. | Click or tap here to enter text. |
Release for contacting references
I hereby authorize HydroWorx to contact any of the above references. I further authorize such references to release any information concerning me as they deem appropriate. I release and forever discharge HydroWorx, its agents or employees, and the above-named references, their agents or employees, from any and all liability, suits or causes of action arising in any manner from HydroWorx contacting such references.
I understand that this Release prevents me from instituting any claim, lawsuit or other legal action based on any information or any reference provided to HydroWorx.
DATE: Click or tap here to enter text.
Signature of Applicant: Click or tap here to enter text.
Notice to Applicant
THE FOLLOWING SECTION CONTAINS IMPORTANT INFORMATION REGARDING YOUR LEGAL RIGHTS AND CONTAINS IMPORTANT CERTIFICATIONS AND RELEASES OF LIABILITY. PLEASE READ IT CAREFULLY BEFORE SIGNING.
I understand that, if hired, I shall be employed “at will” and that nothing contained in HydroWorx employment application, personnel policies or other written documents, nor any oral statements made to me by HydroWorx’s representatives in connection with my application for employment or at any other time, shall constitute an express or implied employment contract. I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time with or without notice or cause.
I certify that the facts contained in this Application are true and complete to the best of my knowledge and understand that if HydroWorx determines that the Application contains information that is false, incomplete, or a misrepresentation, it may decline my application for employment, withdraw any job offer that may be extended to me, or terminate my employment.
The Company conducts pre-employment drug tests and background checks, and you will be required to authorize the Company to conduct a drug test and background check. In connection with the background check, you will be provided information required by state and/or federal law (the Fair Credit Reporting Act) and authorization forms to be signed by you. The Company also may conduct drug tests during your employment as may be required by state or federal law, or our customers and clients.
By signing below, I acknowledge that I have read, understood and voluntarily agree to the above.
DATE: Click or tap here to enter text.
Signature of Applicant: Click or tap here to enter text.