Open Positions

HVAC Technicians, Installers, Plumbers and Office Administrators

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Position applied for

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Are you currently or have you ever been on workman’s comp?

Have you ever been employed here before?

Are you related to anyone employed at Blanton & Sons?

Are you legally eligible for employment in this country?

(Proof of US Citizenship or Immigration status will be required upon employment)

Type of employment desired

Date available for work

YYYY

Salary required

(per hour)

Have you ever been convicted of a crime and/or been on probation?

If yes, please explain

Driver’s License #

State

Expiration

YYYY

Issued

YYYY

Date of birth

YYYY

Employment History

Start date

YYYY

Last day

YYYY

Salary start

Salary end

Employer

Job title

Supervisor

Phone

(###)

###

####

Address

Job responsibilities

Reason for leaving

Education Background

High School

Name of school, location, graduated, diploma/degree?

College

Name of school, location, graduated, diploma/degree?

Referral source

Did a current employee refer you for a position opening?

If so, please provide their name

First Name

Last Name

Are you answering an ad in the newspaper?

References

List three character references that are not related to you.

Name

First Name

Last Name

Phone

(###)

###

####

Years known

Name

First Name

Last Name

Phone

(###)

###

####

Years known

Name

First Name

Last Name

Phone

(###)

###

####

Years known

Emergency Contacts

Name

First Name

Last Name

Relationship

Phone

(###)

###

####

Agree and sign

I certify that all information I have provided in order to apply for and secure work with the Employer is true, complete and correct. It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from Employers service if I have been employed or offered employment. Furthermore, I understand that I am just as free to resign at any time; the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurance to the contrary, expressed or implied. I give the Employer the right to conduct a thorough investigation of my background, including, but not limited to a credit history profile, drug screening and driving record check. I understand that the employer is not obligated to offer me any position or retain me if I am hired. I further understand that any offer of employment may be withdrawn pending the outcome of a background/driving/drug check. I hereby release from liability the Employer, Blanton’s Mechanical & Sons which includes, but not limited to managers and representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. I understand that the Employer does not lawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration of employment on a basis prohibited by applicable local, state or federal law. I also understand that if I am hired, I will be placed on a ninety-probationary period, and I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

Applicant signature

Type full name to sign

Date

Today's date

YYYY

Authorization/Consent and Release Form for Drug and/or Alcohol Testing

I understand that it is the policy of Blanton & Sons to maintain a drug and alcohol free workplace and thereby facilitate a safe, healthy and productive work environment for all Blanton’s Mechanical & Sons. Associates. In furtherance of this policy, and as a condition of my employment or continued employment with Blanton & Sons, I hereby consent to the administration of drug and /or alcohol testing by the Company or its agents and to the taking and testing of any samples including, but not limited to urine, breath and substances found on or around the associate in question for this purpose. I hereby authorize and consent to the release of any test reports on such samples to the Company or its designees, including, but not limited to any physician designated as Medical Review Officer (“MRO”) by the company. I further consent to the company’s use of test results in determining whether to employ or continue to employ me. I consent to the release of these test results in connection with any administrative or judicial procedures which may arise as a result of any decisions by the company related to my continued employment. I hereby release and discharge the company and all those participating in its drug and/or alcohol testing program, including the collection site, testing laboratory, the MRO and each of its officers, directors and associates from any and all liabilities, claims or demands arising from the administration of a drug and/or alcohol test, including, but not limited to the taking and testing of a sample, and release of the test results to the company. This release includes, but is not limited to all claims of defamation, invasion of privacy, unlawful detention or any other sort of contract claim. I agree to pay the $60.00 testing fee should the results be positive on any of the tests. I have read the above and fully understand and agree with its contents. I am signing this form knowingly, voluntarily and without duress.

Applicant Signature

Type full name to sign

Date

Today's date

YYYY

Authorization and Release for the Procurement of a Consumer and/or Investigative Report

I the undersigned consumer do hereby authorize Blanton & Sons by and through any independent contractors to procure a consumer report and/or investigative report on me. These above-mentioned reports may include, but not limited to, employment and education verifications: personal references; personal interviews; my personal credit history based on reports from any credit bureau; my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/records; any other public record. I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any investigative upon consumer report prepared on me upon my written request to an independent contractor of our choice that is made within a reasonable time after the date hereof. I also understand that I may receive a written summary of my rights under 15U.S.C. 1681 et. Seq... I further authorize any person, business or entity or government agency who may have information relevant to the above to disclose the same to Blanton & Sons by and through an independent contractor, including, but not limited to any courthouse, any public agency, any and all law enforcement agencies, and any and all credit bureaus, regardless of whether such person, business entity of government agency compiled the information itself or received it from other sources. I hereby release Blanton & Sons and any independent agencies and any other persons, business entities and government agencies, whether public or private, from any and all liability, claims and/or demands, of whatever kind, to me. My heirs or others making such claims or demand on my behalf, for procuring, selling, providing, brokering and/or assisting with the compilation or preparation of the consumer report and/or investigative consumer report hereby authorized.

Signature

Type full name to sign

Date

Today's date

YYYY

I have received the Summary of Your Rights under the Fair Credit Reporting Act provided to me along with this application packet. Please see last page for signature.

Signature

Type full name to sign

Other names used within the past 5 years

Please list all addresses in the last 5 years:

Current address

Former address

Have you ever been injured on the job or ever filed workman’s compensation?

If yes, please explain

List any medical conditions that may affect your ability to perform job duties or drive a company vehicle

Summary of Your Rights under the Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA) is designated to promote accuracy, fairness and privacy of information in the files of every “consumer reporting agency” (CRA). Most CRA’S are credit bureaus that gather and sell information about you such as if you pay your bills on time or have you filled bankruptcy-to creditors, employers, landlords and other businesses. You can find the complete text of the FCRA gives you specific rights, as outlined below. You may have additional rights under state law. You may contact a state or local consumer protection agency or a state attorney general to learn those rights. You must be told if information in your file has been used against you. Anyone who uses information from a CRA to take action against you such as denying application for credit, insurance or employment-must tell you, and give you the name, address and phone number of the CRA that provided the consumer report. You can find out what is in your file. At your request, a CRA must give you the information in your file, and a list of everyone who has requested it recently. There is no charge for the report if a person has taken action against you because of information supplied by the CRA, if you request within 60 days of receiving notice of the action. You are also entitled to one free report every twelve months upon your request if you certify that (1) you are unemployed and plan to seek employment within 60 days, (2) you are on welfare, or (3) your report is inaccurate due to fraud. Otherwise, a CRA may charge you up to eight dollars. You can dispute inaccurate information with the CRA. If you tell a CRA that your file contains inaccurate information, the CRA must investigate the items (usually within 30 days) by presenting to its information source all relevant evidence you submit, unless your dispute is frivolous. The source must review your evidence and report its findings to the CRA. The source must also advise national CRA’s-to which it has provided the data-of any error. The CRA must give you a written report of the investigation and a copy of your report if the investigation results in any change. If the CRA’s investigation does not resolve the dispute, you may add a brief statement to your file. The CRA must normally include a summary of your statement in future reports. If an item is deleted or a disputed statement is filed, you may ask that anyone who has recently received your report be notified of the change. Inaccurate information must be corrected or deleted. A CRA must remove or correct inaccurate or unverified information from its files, usually within 30 days after you dispute it. However, the CRA is not required to remove accurate data from your file unless it is outdated (as described below) or cannot be verified. If your dispute results in any changes to your report, the CRA cannot reinsert into your file a disputed item unless the information source verifies its accuracy and completeness. In addition, the CRA must give you a written notice telling you it has reinstated the item. This notice must include the name, address and phone number of the information source. You can dispute inaccurate items with the source of the information. If you tell anyone-such as a creditor who reports to a CRA-that you dispute an item, they may not then report the information to a CRA without including a notice of your dispute. In addition, once you’ve notified the source of the error in writing, it may not continue to report the information if it is in fact an error. Outdated information may not be reported. In most cases, a CRA may not report negative information that is more than ten years for bankruptcies. Access to your file is limited. A CRA may provide information about you only to people with a need recognized by the FCRA- usually to consider an application with a creditor, insurer, employer, landlord or other business. Your consent is required for reports that are provided to employers or reports that contain medical information. A CRA may not give out information about you to your employer, or prospective employer with your written consent. A CRA may not report medical information about you to creditors, insurers or employers without your permission. You may choose to exclude your name from CRA lists for unsolicited credit and insurance offers. Creditors and insurers may use file information as the basis for sending you unsolicited offers of credit or insurance. Such offers must include a toll-free number for you to complete and return the CRA form provided for this purpose, you must be taken off the lists indefinitely. You may seek damages from violators. If a CRA, a user or (in some cases) a provider of CRA data, violates the FCRA, you may sue them in state or federal court.

Driver’s Privacy Protection Act Consent Form

Be signing this consent form, I authorize Blanton & Sons and Builders Mutual, acting as their broker, to obtain personal information contained in my records with the State Department of Motor Vehicles. I understand that my personal information may be used for the purpose of evaluating my employment. This information may be shared with Builders Mutual, my employer (or prospective employer) and their insurance company. I am also authorizing that my personal information may be obtained from time to time by those parties indicated above, as necessary to evaluate my continued insurability and employability. South Carolina Motor Vehicle reports may be obtained from the website listed below. https://www.scdmvonline.com/DMVpublic/trans/DrvRecWarn.aspx

Driver's Name

First, Middle Initial, Last

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Driver's License Number