A. W. Therrien Company, Inc
Application for employment
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
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.
WORK TASKS AND PHYSICAL DEMANDS
REQUIRED TO BE A ROOFER
1. Working at heights and outdoors in various weather
conditions ie. direct sunlight, cloud cover, heat, cold, rain,
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