Home › NW Regional – Seattle Office Employment Application
Last Name * :
First Name * :
Middle Name * :
Business Telephone:
Home Telephone * :
Email * :
Address * :
City * :
State and Zip * :
Address :
City :
State and Zip :
Position applying for * :
Regular full-time work * :YesNo
Regular part-time work* :YesNo
Temporary part-time work* :YesNo
What days and hours are you available for work * :
If applying for temporary work, during what period of time will you be available:
Are you available for work on weekends * :YesNo
Would you be available to work overtime, if necessary * :YesNo
If hired, on what date can you start work * :
Salary desired * :
Would you be available to travel, if necessary * :YesNo
Have you ever applied to or worked for ARI before * :YesNo
If yes, when?
Do you have any friends or relatives working for ARI * :YesNo
If yes, state name(s) and relationship :
Why are you applying for work at ARI? *
If hired,would you have a reliable means of transportation to and from work * :YesNo
Are you at least 18 years old * :YesNo(If under 18, hire is subject to verification that you are of minimum legal age.)
If hired, can you present evidence of your citizenship or proof of your legal right to live and work in this country * :YesNo
Are you able to perform the functions of the job for which you are applying * :YesNo
If no, describe the functions that cannot be performed:
(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)
Are you able to perform all other duties of the job for which you are applying * :YesNo
If no, describe the functions that cannot be performed
(Note: Hire may be subject to passing a medical examination, and to skill and agility tests.)
Have you ever been convicted of a criminal offense (felony or serious misdemeanor)? (Convictions for marijuana-related offense that are more than two years old need not be listed) * :YesNo (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
If yes, state nature of the crime(s), when and where convicted and disposition of the case
Are you currently employed * :YesNo
If so, may we contact your current employer:YesNo
High School:
Name and Address * :
Name of years completed * :
Did you Graduate *:YesNo
Degree or Diploma :
College/ University:
Name and Address:
Name of years completed:
Did you Graduate:YesNo
Degree or Diploma:
Vocational/Business/Union/Certifications:
Are you a member of a Union?YesNo
If you are a member of a Union, which Trade is it:
If you are a member of a Union, list your Local #:
Are you a Journeyman?YesNo
Are you an Apprentice?YesNo
If you are an Apprentice, what level are you?
Health Care:
Many of our customers (clients) do not speak English. Do you speak, write or understand any foreign languages * :YesNo
If yes, which language(s)?
Do you have any other experience, training, qualifications or skills which you feel make you especially suited for work at ARI? If so, please explain:
List below all present and past employment starting with your most recent employer (last 10 years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume.
Name of Employer :
No :
Street :
State :
Zip :
Type of Business :
Telephone No :
Your Supervisors Name :
Your Position and Duties :
Date of Employment :
Weekly Pay :
Reason for Leaving :
Name of Employer:
Your Position and Duties
Date of Employment:
Weekly Pay:
Reason for Leaving:
Have you obtained any special skills or abilities as the result of service in the military * :YesNo
If so, describe:
List below three persons not related to you who have knowledge of your work performance within the last three years.
Name * :
Address
No * :
Street * :
State * :
Zip * :
Occupation * :
Telephone No * :
Number of Years Acquainted * :
Address:
Have you ever worked:
On supported scaffold * :YesNo
If yes, how many years:
On suspended scaffold * :YesNo
Operating boom, scissors, or forklift * :YesNo
If yes, how many years?
Operating powder-actuated tools (e.g., Hilti) * :YesNo
In a confined space * :YesNo
Do you have any of the following certification cards or certificates (Please check that apply):OSHA 10First Aid/CPRSuspended ScaffoldSupported ScaffoldConfined SpaceFall ProtectionBoom, Scissors, Forklift
