Around the Town Heating and Cooling Inc.

Employment Application

Requirements: Min. 10 years verifiable experience.

Application Information
 
Full Name:
Last
First
M.I.

Date
         
Address: Street Address
Apartment/Unit #
     
 
City
State
ZIP Code
       
Phone: E-Mail Address:
       
Position Applied for:
   
Date: Available: Social Security No.: Desired Salary: $
           
Are you a U.S. Citizen? If no, are you autohorized to work in the U.S.
       
Years as an electrician?
   
Have you ever been convicted of a felony? Able to work evenings, overnights & weekends?
       
If yes, explain:
   
Education
 
High School: Address:
       
From: To: Did you graduate? Yes No Degree:
               
College: Address:
       
From: To: Did you graduate? Yes No Degree:
               
Other: Address:
       
From: To: Did you graduate? Yes No Degree:
               
References
  *Please list three professional references
   
Full Name: Relationship:
       
Company: Phone:
       
Address:
   
Full Name: Relationship:
       
Company: Phone:
       
Address:
   
Full Name: Relationship:
       
Company: Phone:
       
Address:
   
Previous Employment
 
Company: Phone:
       
Address: Supervisor:
       
Job Title: Starting Salary: Ending Salary:
           
Responsibilities:
   
From: To: Reason for Leaving:
           
May we contact your previous supervisor for a reference? Yes No
   
Company: Phone:
       
Address: Supervisor:
       
Job Title: Starting Salary: Ending Salary:
           
Responsibilities:
   
From: To: Reason for Leaving:
           
May we contact your previous supervisor for a reference? Yes No
   
Company: Phone:
       
Address: Supervisor:
       
Job Title: Starting Salary: Ending Salary:
           
Responsibilities:
   
From: To: Reason for Leaving:
           
May we contact your previous supervisor for a reference? Yes No
   
Military Service
 
Branch: From: To:
           
Rank at Discharge: Type of Discharge:
       
If other than honorable, explain:
   
Disclaimer and Signature
 
I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
 
Online Signature: Date: