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In Memory of C.D. Gregory “Bubber”
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Departments
Company History
Turnkey Services
Supply Partners
Contact
Credit Application
Staff
Careers
In Memory of C.D. Gregory “Bubber”
Employment
Builders Supply Job Application
Date
Month
Day
Year
Personal Information
Name
*
First
Middle
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone
*
Referred By
Are you 18 years or older?
Yes
No
If answer above is No, list date of birth
Month
Day
Year
General
Are you legally eligible for employment in the United States?
Yes
No
Proof of eligibility will be required before you can be employed.
What date are you available for employment?
Month
Day
Year
Have you ever applied for a position with this Company?
Yes
No
If answer above is Yes, when did you apply?
Month
Day
Year
Are you presently on layoff or leave of absence form any other company?
Yes
No
If answer above is Yes, explain here:
Have you ever pleaded guilty, "no contest" to, or been convicted of a crime other than a minor traffic violation?
Yes
No
If answer above is Yes, please state citation, date and place where offense occurred
Education
Elementary School Attended
Select Elementary School Grade Completed
1
2
3
4
5
6
7
8
High School Attended
Select High School Grade Completed
1
2
3
4
Did you graduate?
Yes
No
College(s): note Location, Dates Attended, Date Graduated, Date Degree Received/Expected, Course Major/Field
Other job-related educational institutions
Work References
Type of employment desired?
Full-time
Part-time
Summer
Will you work shifts?
Yes
No
For what type of position are you applying?
Are you restricted to working only certain hours of the day?
Yes
No
If Yes, indicate what hours you are available
Are you restricted from working certain days of the week?
Yes
No
If Yes, list days of the week you are available
Driving Information
Do you have a current driver's license?
Yes
No
Class
State
License Number
Expiration Date
Has your driver's license ever been suspended or revoked?
Yes
No
If Yes, explain circumstances:
List all moving traffic violations in the past five (5) years:
Include Offense, Date and Location for each.
Former Employers
List below last four employers, starting with last one first.
Name of Employer 1
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Provide Start and End Dates, Salary, Position Held, Reason for Leaving
Name of Employer 2
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Provide Start and End Dates, Salary, Position Held, Reason for Leaving
Name of Employer 3
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Provide Start and End Dates, Salary, Position Held, Reason for Leaving
Name of Employer 4
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Provide Start and End Dates, Salary, Position Held, Reason for Leaving
References
Give below the names of three persons, not related to you, whom you have known at least one year.
Reference Name 1
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Business and Years Known
Reference Name 2
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Business and Years Known
Reference Name 3
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Business and Years Known
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