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Employment Application

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Applicant Information

Name*
Address*
Email*
Are You At Least 18 Years Old?*
Can You Submit Proof Of Age?*
Do You Have A Valid Driver's License?*
Date Available For Work*
Are There Times You Can't Work?*

High School / GED

Business / Trade / Tech Schools

University / College

Other Training / Education

Work Experience 1

Please give us some information about the latest position you have held.
May We Contact?*
Company Address*
Start Date*
End Date

Work Experience 2

May We Contact?
Company Address
Start Date
End Date

Work Experience 3

May We Contact?
Company Address
Start Date
End Date

Character References

Please list three people who we can reach out to for a character reference.

Closing Terms

I authorize the company to conduct a reference and a background investigation, which may include driving record, criminal record, credit, and educational background and professional license. I understand and agree that employment may be contingent upon the results of the reference checks and the background investigation. I understand I will be required to provide information for compliance with the Immigration Reform and Control Act. I understand that I may be required to have a physical examination, drug test, and pre-employment evaluations. I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by the company unless I have indicated to the contrary. I authorize the references listed above to provide the company any and all information concerning my previous employment and any pertinent information that they may have. Further, I release all parties and person from any and all liability for any damages that may result from misrepresentation, falsification, or material omission of information of this application may result in my failure to receive an offer, or if I am hired, in my dismissal from employment. In consideration of my employment, I agree to conform to the rules and standards of the company and agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the company. Please check "yes" below to acknowledge that you understand and accept the above statements.
Do You Acknowledge And Accept These Terms?*

Signature

All information contained in this application is true to the best of my knowledge and belief. I understand that misrepresentation or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am selected/hired. I authorize this company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment backround for the purpose of verifying any information I have provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to my employment or me. regardless of whether or not I become elected/hired by this company, I recognize that this application is not and should not be considered a contract of employment for any definite period of time. If employed, I understand that I have been hired "At-Will" of the employer and my employment may be terminated at any time, with or without cause and with or without notice.
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Date*
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Our Service Area

Heartland Home Improvements proudly serves Harrisonburg City and Rockingham County, including Bergton, Bridgewater, Broadway, Criders, Dayton, Elkton, Fulks Run, Grottoes, Hinton, Keezletown, Lacey Spring, Linville, Massanutten, McGaheysville, Montezuma, Mt. Crawford, Penn Laird, Pleasant Valley, Port Republic, Singers Glen, Timberville, and surrounding areas. We bring high standards and quality craftsmanship to all your home improvement and renovation projects.

Please note: due to continuing supply issues and increased lead times, our service area is subject to change. We apologize for any inconvenience.

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975 Cottontail Trail
Mount Crawford, VA 22841
Monday-Friday: 9am-5pm

540.908.2400
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