HVAC/Refrigeration Technician Application

Application For Employment
FIRST NAME*
LAST NAME*
ADDRESS*
TELEPHONE*
LAST FOUR OF SOCIAL SECURITY #
DATE AVAILABLE FOR EMPLOYMENT
ARE YOU EMPLOYED NOW?
YES
NO
MAY WE CONTACT YOUR PRESENT EMPLOYER?
YES
NO
IF YES, GIVE NAME:
Are you prevented from lawfully becoming employed in this country because of visa or immigration status:
YES
NO
If applying for a position where driving is required, do you have a valid driver’s license in this state?
YES
NO
License #
Are you available to work?
FULL TIME
PART TIME
OVER TIME
Have you been convicted of a felony?
(Please note that a "YES" answer will not bar you from consideration for employment.)
YES
NO
lf yes, please explain:
Education
HIGH SCHOOL
COLLEGE TECH /TECH SCHOOL
School Name & Address
Years Completed
9 10 11 12
1 2 3 4
Course of Study

Special Skills, Qualifications and Considerations:

Summarize special skills, qualifications, licenses and employment or other activities related to the job you are seeking
References:
List four (4) non-relatives who are familiar with your qualifications, work history, and ability.
Name
Occupation/Relationship
Years Known
Telephone
Employment Experience:
Employer 1
Employer*
Supervisor's Name*
Address*
Your Job Position*
Telephone Number*
Employed From*
To*
Your Salary: Starting/Ending*
Duties*
What did you like most about your job?*
Reason for Leaving*
Employer 2
Employer
Supervisor's Name
Address
Your Job Position
Telephone Number
Employed From
To
Your Salary: Starting/Ending
Duties
What did you like most about your job?
Reason for Leaving
Employer 3
Employer
Supervisor's Name
Address
Your Job Position
Telephone Number
Employed From
To
Your Salary: Starting/Ending
Duties
What did you like most about your job?
Reason for Leaving
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.
I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. By signing below, I authorize All -Tech Service Company, Inc. to investigate all statements contained in this employment application, as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if lam employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character and qualifications.
If hired I will be responsible for familiarizing myself with all rules and regulations of All-Tech Service Company, Inc. as they presently exist or are later modified, /f hired, I understand my employment can be terminated, at the discretion of All-Tech Service Company, Inc. or at my option, without notice, at any time and for any reason.
I also understand that no representative of All-Tech Service Company, Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of All-Tech Service Company, Inc.
I understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time.
I have read, understood, and agree with the above.
Date
Email
This application is valid for only ninety (90) days from the date I signed. If I want to be considered for job openings more the ninety (90) days from date signed, I will submit a new application.