Online Employment Application

Position Applying For
 Name & address of former employer
Name *

A name is required.
Phone *

A phone number is required. 		Supervisor
Email *

An email address is required. 		Dates employed (from/to)
Other Phone
 Salary (start/end)
Reason for leaving
 Position held
If presently employed, why do you desire to change your position?
 Are you able to perform the specific job tasks with or without reasonable accommodation?
Yes   No
If you are able to perform one or more of the job functions with reasonable accommodation, please describe how you would perform the tasks and with what accommodation?
 Can you meet the attendance requirements of the job?
Yes   No
 

EDUCATION
Level of Education Name Address Major Last Year Completed Degree
High School  1
 2
 3
 4
Business School  1
 2
 3
 4
College  1
 2
 3
 4
Graduate Work  1
 2
 3
 4
Are you planning to pursue further studies?
Yes   No 		Do you speak French fluently?
Yes   No
If so, when, where, and what courses?
 

PERSONAL REFERENCES


Please list the names of three personal references who have known you well during the past FIVE or more years. You may include the names of friends or acquaintances presently employed by the Rhoades Building Products but do not list relatives, former employers or fellow employees.
Name Address No. of Years Acquainted Phone Number
Have you ever been convicted of a criminal offense involving dishonesty or breach of trust (including but not limited to, robbery, larceny, shoplifting, embezzlement, forgery, perjury, tax evasion, etc.)?
Yes   No

PLEASE READ BEFORE SUBMITTING

I understand that any employment will be on an at-will basis and that my employment may be terminated, with or without cause or notice, at any time, at my option or that of Rhoades Building Products, Inc. I understand that no representative of Rhoades Building Products, Inc. has any authority to enter into any agreement for continuing employment for any specific period of time or which is contrary to the foregoing without written approval of the President at Rhoades Building Products, Inc. I authorize Rhoades Building Products, Inc. to contact any or all of my current and prior employers and references and authorize them to provide all information requested of them by Rhoades Building Products, Inc. and release all persons from liability for any damage or injury that may result from furnishing such information to Rhoades Building Products, Inc. I authorize Rhoades Building Products, Inc. to verify all information set forth in my application and received during the application process by any and all other means authorized or permitted by law. I certify that I have provided truthful and complete responses to all inquiries in the application. Should I be employed by Rhoades Building Products, Inc., I understand that any misrepresentation, falsification, or omission may result in immediate dismissal. If employed by Rhoades Building Products, Inc., I will abide by its rules and regulations, which I understand, are subject to change.

If extended an offer of employment, I consent to undergo a pre-placement physical examination by a health professional selected by Rhoades Building Products, Inc. I understand that any offer of employment is conditioned upon the results of this post-offer examination.

Rhoades Building Products, Inc. is an equal opportunity employer dedicated to a policy of compliance with all federal, state and local laws regarding non-discrimination in employment. No question on this application is intended to secure information to be used for unlawful purposes.

Consistent with the provisions of the Americans with Disability ACT (ADA) and the Maine Human Rights Act (MHRA), applicants may request accommodations needed to participate in the application process.

By submitting this form, I agree to the terms and conditions.
Date
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