Personal Information
First Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
Email
Phone
Date Available To Begin Work
Date Of Birth
Are you currently employed?
EMPLOYMENT HISTORY (Include current or most recent position)
Employer Name
Employer Phone
Employer Address Line 1
Employer Address Line 2
Employer City
Employer State
Position
Supervisor Name
Employment Start Date
Employment End Date
Describe Duties Performed
Employer 2 Name
Employer 2 Phone
Employer 2 Address Line 1
Employer 2 Address Line 2
Employer 2 City
Employer 2 State
Position 2
Supervisor Name 2
Employment Start Date 2
Employment End Date 2
Describe Duties Performed 2
Employer 3 Name
Employer 3 Phone
Employer 3 Address Line 1
Employer 3 Address Line 2
Employer 3 City
Employer 3 State
Position 3
Supervisor Name 3
Employment Start Date 3
Employment End Date 3
Describe Duties Performed 3
Summarize training, skills, licenses, certifications, or educational degrees that may assist you in performing the job for which you are applying
References
Provide two references, two from employers (If you have sent these already, please skip. Additionally, please do not include any family or friends only leverage professional relationships)
Name 1
Relationship 1
Phone 1
Years Know 1
Name 2
Relationship 2
Phone 2
Years Know 2
Optional Info
The following questions are being asked to identify demographics for 6 Brick’s to make sure we are meeting our goals as a diverse organization with equal opportunity. If you have any comments, questions or concerns please email us at contactus@6bricks.com
Please read carefully before signing.
6Brick’s is an equal opportunity employer. 6Brick’s does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status, or any other protected class under the law.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for 6 Brick’s to hire me. If I am hired, I understand that either 6Brick’s or I can terminate my employment with or without reason, with or without cause or prior notice. I understand that no representative of 6Brick’s has the authority to make any assurance to the contrary.
I attest with my signature below that I have given to 6Brick’s true and complete information on this application. No requested information has been concealed. I authorize 6Brick’s to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
Digital Signature
Date
Referred by a 6Brick’s employee? Please provide their name
