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Please fill out this application form completely. We appreciate your interest in Merico Abatement Contractors, Inc..

Fields marked with an * are required

Application for Employment

Personal Information

Full Name (first, middle, last) *

Area code / phone *

Email *

Address *

Address

City *

US State *

Zip *

Position applying for: *

Expected salary (do not use $ symbol)

How did you hear about Merico Abatement Contractors, Inc.? *

Are you at least 18 years old? *

Yes
No

If under 18, can you furnish a work permit?

Yes
No

Are you a U.S. citizen or alien lawfully authorized to work in the U.S.? *

Yes
No

With accommodation, can you perform the essential function of the job?

Yes
No

Have you ever been convicted of a felony?

Yes
No

If so, state offense, date, location:

Have you ever been employed by Gregg Industrial Insulators or Merico Abatement? *

Yes
No

If so, state position held: *

Date(s) of hire: *

To Our Applicant

We appreciate your interest in seeking employment with Merico Abatement Contractors, Inc. and assure you that we are sincerely interested in pursuing your application for employment. A clear understanding of your skills and work history will aid us in considering you for the position for which you are applying. Merico considers applications for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, disability, or any other legally protected status.

Education

High School you attended *

City, State *

Dates attended (start, end) *

Did you graduate? *

Yes
No

College / University

City, State

Dates attended

Did you graduate?

Yes
No

Degree / major

Other education

City, State

Dates attended

Did you graduate?

Yes
No

Degree / major

Work Availability

Please indicate the days and times you are available to work. For example, "8am-5pm" or NO if not available that day.

Monday *

Tuesday *

Wednesday *

Thursday *

Friday *

Saturday *

Sunday *

EMPLOYMENT History

Beginning with your present or most recent position, list your last three jobs. Please note any full or part-time employment and periods of unemployment. Please indicate the reason for any length of unemployment between present application date and most recent position.

Present or most recent employer *

Employer Phone

Employer Address

Employer City

Employer State

Employer Zip

Starting Date

Ending Date

Starting Pay

Final Pay

Supervisor

Reason for leaving

Your full name if different

Job title and duties

Employer 2

Employer 2 Phone

Employer 2 Address

Employer 2 City

Employer 2 State

Employer 2 Zip

Starting Date 2

Ending Date 2

Starting Pay 2

Final Pay 2

Supervisor 2

Reason for leaving 2

Your full name if different 2

Job title and duties 2

Employer 3

Employer 3 Phone

Employer 3 Address

Employer 3 City

Employer 3 State

Employer 3 Zip

Starting Date 3

Ending Date 3

Starting Pay 3

Final Pay 3

Supervisor 3

Reason for leaving 3

Your full name if different 3

Job title and duties 3

References

Reference 1: Name & Occupation

Reference 1: Phone

Reference 1: Relationship to you

Reference 2: Name & Occupation

Reference 2: Phone

Reference 2: Relationship to you

Reference 3: Name & Occupation

Reference 3: Phone

Reference 3: Relationship to you

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