Contact Info:

For Tax purposes, a valid Social Security number is required ON THE FIRST DAY OF WORK. If the number cannot be verified by the Social Security Administration, it is grounds for immediate termination.

Employment History

Current Employer (or another previous)

Previous Employment

References

Emergency Contact Info

I Certify that my answers are true and complete to the best of my knowledge. I authorize A.W. Therrien Company to make such investigations and inquiries of my previous employment, and other related matters, as may be necessary for my employment decision. I hereby release any previous employer or persons from all liability in responding to inquiries in connection with my application. I have read and understand the description of the work, tasks and the physical demands required of me to perform the work. I understand and am capable of complying with the demands of this job. In the event that i am employed, I understand that false or misleading information given in my application or interview may result in discharge.

1. Working at heights and outdoors in various weather conditions ie. direct sunlight, cloud cover, heat, cold, rain, snow. 

2. Climbing ladders (6’-52’)

3. Working in man lifts / scissor lifts (42’-120’) 

4. Use of powertools (drills, circular saws, sawzalls, hammerdrills, heat guns, etc.)

5. Use of hand tools (hammer, axe, hand rollers, scissors, shovel, brooms, etc.) 

6. Physical Demands that include but are not limited to: frequent lifting of objects weighing 50-100 lbs., bending at the waist, kneeling, crawling, squatting, reaching, climbing, standing and walking