Residential Info Request | Naylor & Breen Builders

By completing this application below you are seeking to join a team of hardworking professionals who are dedicated to consistently delivering outstanding service to our clients and who contribute to the financial success of this company. [ DOWNLOAD APPLICATION ]

*REQUIRED FIELDS

APPLICANT INFORMATION

Last Name *

First Name *

M.I.

Today’s Date

Street Address *

Apartment/Unit #

City *

State

Zip

Phone *

E-mail Address *

Date Available

Desired Salary *

Position Applied for *

Are you a citizen of the United States?

Yes

If no, are you authorized to work in the U.S.?

Yes

Have you ever worked for N&B before?

Yes

If so, when?

Do you have friends/family working for N&B?

Yes

Name?

Do You have a valid drivers License?

Yes

EDUCATION

College

Address

From

Did you graduate?

Yes

Degree

High School

Address

From

Did you graduate?

Yes

Degree

Other

Address

From

Did you graduate?

Yes

Degree

MILITARY SERVICE

Branch

From

Rank at Discharge

Type of Discharge

If other than honorable, explain

REFERENCES

Please list three professional references (non-family, familiar with your work abilities who’ve known you more than one year).

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

MOST RECENT OR RELEVANT EMPLOYER

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

SECOND MOST RECENT OR RELEVANT EMPLOYER

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

THIRD MOST RECENT OR RELEVANT EMPLOYER

Company

Phone

Address

Supervisor

Job Title

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

COMPUTER SKILLS (Include software titles and years of experience)

Word Processing

Years

E-Mail

Years

Spreadsheet

Years

Internet

Years

Presentation

Years

Other

Years

OTHER INFORMATION YOU WOULD LIKE US TO KNOW ABOUT YOUR QUALIFICATIONS

DISCLAIMER AND SIGNATURE

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.

Signature *

Date *

IMPORTANT INFORMATION TO THE APPLICANT

Naylor & Breen Builders, Inc. is an Equal Opportunity Employer. We do not discriminate in hiring or employment in accordance with the requirements of all applicable local, state and federal laws, on the basis of race, color, creed, sex, national origin, age, veteran status or physical or mental disability or any basis other than factors that affect the ability to perform the work required.

There are pre-conditions for employment. We reserve the right to perform drug or alcohol testing and/or background investigations. We ask your permission to conduct such testing prior to employment and any time that such factors may affect work performance or possibly be related to any accident or incident. Your permission is implied by this application.

The use, possession, or being under the influence of illegal drugs or alcohol while on company time is prohibited. In addition, being under the influence of legally prescribed medication that causes either physical or mental impairment of judgment for work performance while on company time is also prohibited.

If you are hired, you will be required to provide a copy of your Driver’s license, proof of legality to work in the United States (INS form I-9), an Income Tax Deduction form (W-4), and other personal contact and health related information. Employment application materials will be kept on file for one year.