Classic Air Care - Heating & Air Conditioning

APPLICATION FOR EMPLOYMENT
Pre-employment Questionnaire - Equal Opportunity Employer

Personal Information
Name:
Present Address:
Permanent Address:
Phone Number: Referred By:

Employment Desired
Position:    Date you can start:
Salary Desired:    Are you currently employed? Yes No
If currently employed, may we inquire of your present employer? Yes No
Ever applied to this company before? Yes No    Where?    When?

Name & Location of School
Grammar School   Years Attended   Did you graduate? Yes No
High School   Years Attended   Did you graduate? Yes No
Trade, Business or Correspondence School   Years Attended   Did you graduate? Yes No

General

Subjects of special study/research work or special training/skills:

U.S. Military or Naval Service
Rank

Former Employers (List below last 4 employers, starting with the most recent one first)

Name of Employer
Employer's Address
Dates Employed From To
Salary Position
Reason for Leaving

References - Give below the names of three persons not related to you, whom you have known at least one year.
Name:    Address:   Years Known
Name:    Address:   Years Known
Name:    Address:   Years Known

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this applications shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authroized company representative."

By submitting my application via this form, I am agreeing to the above Authorization.