Sunday, December 17, 2017

Employment

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* Required information.
Last Name, First, Middle Initial *
Today's Date *
Present Address *
Social Security Number *
California Drivers License
Are you a U.S. Citizen? *
Yes
No
If you are not a U.S. Citizen, do you have proof of authorization to work in the U.S.A.?
Yes
No
Person to be notified in case of emergency *
Emergency Contact Phone *
Emergency Contact address *

Educational Record

Jr. High School Name: *
City/State: *
Did you graduate? *
Yes
No
Year: *
High School Name: *
City/State: *
Did you graduate? *
Yes
No
Year: *
College Name: *
City/State: *
Did you graduate? *
Yes
No
Year: *

List any specific course of study or trade school education which applies to the position you are applying for.

School Name: *
City/State: *
Course of Study: *
Details: *
Did you graduate? *
Yes
No
Year: *

Work Experience (List last employer first)

Name of Company #1 *
Company #1 Employments Dates *
Company #1 Position Held *
Company #1 Final Wage *
Company #1 Reason for Leaving *
Name of Company #2 *
Company #2 Employments Dates *
Company #2 Position Held *
Company #2 Final Wage *
Company #2 Reason for Leaving *
Name of Company #3 *
Company #3 Employments Dates *
Company #3 Position Held *
Company #3 Final Wage *
Company #3 Reason for Leaving *
Name of Company #4 *
Company #4 Employments Dates *
Company #4 Position Held *
Company #4 Final Wage *
Company #4 Reason for Leaving *
Name of Company #5 *
Company #5 Employments Dates *
Company #5 Position Held *
Company #5 Final Wage *
Company #5 Reason for Leaving *

NOTE: Chandler's reseves the right to contact previous emploeers to verify any infromation you listed herein.

Expected entry wage: $ *

Name of your immediate supervisor on your last two jobs.

Supervisor #1: *
Phone #1: *
Supervisor #2: *
Phone #2: *
List any special skills or educational training gained through any of your previous employeers: *
Do you have any restrictions on your ability to lift, climb or drive a vehicle? *
Yes
No
If so, list any applicable information:
Have you ever had any industrial accidents or driving accidents in the past? *
Yes
No
If so, list any applicable information:
Have you filed any workmas compensation claims relating to employment related injury in the past? *
Yes
No
If so, list any applicable information:

This application is a pre-employment questionaire. Employment is decided based on evaluation relating to information given during the interview and/or your actual skills in the trade you have applied for.

This questionaire does not represent any form of employment contract if you are hired.

Chandler's Air Conditioning and Refrigeration Inc. is an equal opportunity employer. This form complies with current State and Federal employment practice laws prohibiting any form of employment discrimination.

I have read and understand the contents of the questions asked and statements given in this form. All questions have been answered true and correct.

Applicants signature: *
Date: *
Please attach your resume
Designed for Chandlers AC 2013