First Name: Last Name: Phone:
State: Zip:
Positions Applied For: Salary Desired (Hourly):
Did You Graduate High School?    
Are You Considered A Journeyman?    
Are You A Master Plumber?    
Are You Currently Working?    
If Yes Where?
Have You Ever Worked For JRC Mechanical? If Yes When?

List Your Most Recent Former Employers in Order (Most Recent First)  
Company How Long (To/From) Phone Contact Hourly Rate Position Reason For Leaving

Please Answer Each Questions  
Are You Familiar With Plumbing Hand Tools?
Are You Familiar With B-Tank & Rig?
Can You Use Saw Zall?
Are You Experienced With Drill(s)?
Can You Use Hole Hawg With Bits?  
Do You Have Your Own Transportation?
Do You Have A Valid VA Driver's License?
Please Select Other Licenses That Apply:
How is Your Driving Record?
Will You Work Overtime?  
Will You Work Out of Town If The Company Pays Your Expenses?  
Have You Ever Worked As A Lead Plumber?  
Can You Read Blue Prints?  
Can You Operate A Backhoe?  
If Yes, rate Your Experiences With A Backhoe:  
Can You Operate A Mini-Excavator?  
If Yes, Rate Your Experiences With A Mini-Excavator:  
Have You Been Convicted of A Felony In The Last Seven Years?  
If Yes, Please Explain:
Give Detailed Description Of Other Plumbing Experiences And Projects Completed:
Attach Your Resume: