(PLEASE PRINT OR TYPE)
What knowledge, special technical or computer skills, and/or other qualifications have you acquired from employment or other experience? Include any specific equipment that you can proficiently operate :
Equal Employment Opportunity Form
Federal law prohibits discrimination based on race, color, religion, sex, age, disability, national origin, and veteran status. The following information is used for record keeping purposes in accordance with Equal Employment Opportunity Commission requirements. Complete the following information sheet and return it with your application blank. Please type or print and sign below. You are not required to furnish this information but we encourage you to do so.
Give name, address, and telephone number of three references who are qualified to evaluate your prior performance.
I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision and release East Carolina Ventures, LLC dba Eastern Plumbing from all liability arising from such inquires.
In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in discharge. I understand, also, that I am required to abide by all rules and regulations of Eastern Plumbing.