Partusch Application

Partusch Plumbing & Heating, Inc Application for Employment If you would like to apply for employment on-line, fill out the form below. If you would prefer to fill out and mail your application click here.

First name: Last name:
Address:
Street:
City: State: Zip:
Phone Number:

Person to Contact in case of emergency:
Name:
Address:
Phone:
E-mail Address:

Work Experience:
Please list your work experience in the last two years

Employer:
Phone:
Job Title and Description
Dates of Employment: From: To:
Reason for Leaving:

Employer:
Phone:
Job Title and Description
Dates of Employment: From: To:
Reason for Leaving:

Employer:
Phone:
Job Title and Description
Dates of Employment: From: To:
Reason for Leaving:
Have you ever been injured in the course of employment? If so, describe:
Do you currently suffer from any injury or impairment that may limit your ability to work in any way? If so, please list all injuries or impairments and describe how they might limit your performance.
I understand that if I am accepted for employment with Partusch Plumbing and Heating, Inc., my employment will be "at will." This means that I may voluntarily leave employment upon proper notice and that I may be terminated by Partusch Plumbing and Heating, Inc. at any time for any reason. I understand that any oral or written statements to the contrary with the sole exception of a written employment contract signed by the President are hereby expressly disavowed and are not relied on by me in applying for or in accepting employment. I affirm that all information provided by me on this application is true. I understand that the falsification of any information on this application may result in termination, at the sole discretion of Partusch Plumbing and Heating, Inc. If you would prefer to fill out and mail your application click here (pdf format).

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