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Jeff's Kitchen Bath & Beyond is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, religion, national origin, genetic information, disability, veteran status, sexual orientation/gender identity, citizenship status, marital status or any other status protected by law. We assure you that your opportunity for employment with this employer depends solely upon your qualifications. Applicants with disabilities may be entitled to reasonable accommodation under the terms of the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on the company. Please inform the company’s human resources representative if you need assistance completing any forms or to otherwise participate in the application process. Please answer all questions completely. Resumes are not accepted in lieu of completion of this application. NOTE: This application was designed to use with several types of job positions. Some questions may not be completely applicable to the job position you are seeking; however, we ask that you answer all questions.

Personal

Name(Required)

First Middle Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you over the age of 18?(Required)

Yes

No

If hired, can you provide verification of your legal right to work in the United States?(Required)

Yes

No

Have you ever been involuntarily terminated or requested to resign?(Required)

Yes

No

If Yes, Please Explain

Have you ever worked under a different name?

Yes

No

If Yes, What Name?

Are you able to perform the essential functions of the position as listed and described on the attached job description or as demonstrated by the company representative with or without a reasonable accommodation?(Required)

Yes

No

Do you have a non-compete agreement or are you subject to any restrictive covenant with any of your former employers?(Required)

Yes

No

Education

Grammar/High School(Required)

College/University

Post Graduate

Business/Trade Technical

Describe any other specialized or professional training (such as business or technical school). Include study courses given through public or private employment. State whether degree or certification received.

Skills

If Applicable for Position for Which You Are Applying

Foreign Languages (indicate proficiency to speak, read and write)

PC Skills (Indicate software used)

Other Skills

Do you have any experience, training, qualifications or special skills that you think make you especially suited for work at this company? (Explain)

Employment History

(start with current or most recent employer). Account for all time periods including unemployment, self-employment and military service.

Current / Most Recent Employer

Company Name(Required)

Phone(Required)

From Mo./Yr.(Required)

To Mo./Yr.(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title(Required)

Supervisor Name(Required)

Duties(Required)

Reason For Leaving(Required)

Previous Employer

Company Name(Required)

Phone

From Mo./Yr.

To Mo./Yr.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Job Title

Supervisor Name

Duties

Reason For Leaving

Previous Employer

Company Name

Phone

From Mo./Yr.

To Mo./Yr.

Job Title

Supervisor Name

Duties

Reason For Leaving

Criminal Record

Have you ever been convicted of a crime, pled no contest, had adjudication withheld, or been a defendant in a civil action for an intentional tort?(Required)

Yes

No

Please read carefully, initial each paragraph, and sign below

Initial(Required)

I understand that as a condition of employment I may be required to take a post-offer/pre-employment alcohol/drug test. I further understand that, if management suspects that I am under the influence of drugs or alcohol, I may be required to take a drug/alcohol test. I also understand that I may be required to submit to a random drug/alcohol test during the course of employment.

Initial(Required)

I understand that all offers of employment are conditioned upon my providing satisfactory documentary proof of my identity and legal right to work in the United States.

Initial(Required)

I hereby acknowledge that I have read the above statements and understand them. I certify that I, the undersigned applicant, have personally completed this application. I declare that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for employment, and will result in my dismissal from employment, if discovered at a later date.

Digital Signature of Applicant(Required)

Date

Driving

Every applicant for employment with Jeff's Kitchen Bath & Beyond must have a clean driving record. Your driving record will be checked with Tallahassee.

To avoid unnecessary time and expense, please verify that you have a clear driving record.

My driving record IS CLEAR and I have no points against my license.(Required)

Yes

No

No. My driving record is NOT CLEAR. Enter the number of points against your license.

Comments

The facts set forth above are true and complete. I understand that if employed, false statements or omissions of information provided may be considered sufficient reason for dismissal. You are hereby authorized to make any investigation or my personal driving history.

Digital Signature of Applicant(Required)

Date

Trade Skills & Licenses

Please complete the following information regarding your skills and licenses.

Select the POSITION you are applying for with Jeff's Kitchen Bath & Beyond.(Required)

Select the TRADE that you are most qualified in.(Required)

Enter any additional training, schooling, etc. that you have had in this trade.

Check any other trades below that you have experience in

Plumbing

Welding

Pipe Fitting

Air Conditioning, Refrigeration

Sheet Metal

Other

List any other equipment (backhoe, core-drill machine, heli-arc welding, etc.) that you can operate (not mentioned above)

Please select your level of experience related to the following.

Can you read Blue Prints & Specs(Required)

Can you install Screw Pipe Systems(Required)

Can you install Weld Pipe Systems(Required)

Can you use a Cutting Torch(Required)

Can you Weld Stainless Steel(Required)

Can you Weld Aluminum(Required)

Can you install Cast Iron Pipe(Required)

Can you install PVC(Required)

Can you install Copper Pipe & Soft Solder(Required)

Can you install Mechanical Pipe(Required)

Can you install Acid Pipe & Lab Systems(Required)

Can you install Glass Pipe(Required)

Can you install and set Fixtures(Required)

Can you troubleshoot Heat Pump Systems(Required)

Do you have Sales Experience(Required)

List any other qualification (such as backhoe or forklift,etc)(Required)

Give a summary of yourself and how you could benefit Jeff's Kitchen Bath & Beyond if hired(Required)

(407) 968-1801

Employment Application For Jeff's KBB

Personal

Employment

Education

Skills

Employment History

Current / Most Recent Employer

Previous Employer

Previous Employer

Criminal Record

Please read carefully, initial each paragraph, and sign below

Driving

Trade Skills & Licenses

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