Employment Application

We are an Equal Employment Opportunity employer and are always looking for qualified workers. If you are interested in joining a team that is dedicated to quality workmanship you can fill out our secure online application or you can download our employment application, fill it out, and email it to daisy@broughmanbuilders.com or mail it to Broughman Builders, 6 Acadia Way, Ellsworth, ME 04605.

Applicant Information

First Name:

Middle Name:

Last Name:

Date of Birth:

Address:

City:

State:

Zip:

Phone:

Mobile Phone:

Email:

What position(s) are you interested in?

Desired Salary:

Date Available:

Are you a citizen of the United States?

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

Have you ever worked for this company?

If yes, when?

Education

High School:

Address:

From:

To:

Did you graduate?

Diploma:

College / University:

Address:

From:

To:

Did you graduate?

Degree:

Other:

Address:

From:

To:

Did you graduate?

Degree:

References

Reference Name:

Relationship:

Company:

Phone:

Address:

Reference Name:

Relationship:

Company:

Phone:

Address:

Reference Name:

Relationship:

Company:

Phone:

Address:

Previous Employment

Company Name:

Address:

Supervisor:

Phone:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason For Leaving:

May we contact your previous supervisor for a reference?

Company Name:

Address:

Supervisor:

Phone:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason For Leaving:

May we contact your previous supervisor for a reference?

Company Name:

Address:

Supervisor:

Phone:

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason For Leaving:

May we contact your previous supervisor for a reference?

Disclaimer & Verification

By entering my initials below, 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.

Initials:

Date:

If you're not a robot, what is 800 + 5?

Employment Application

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