JOIN OUR TEAM JOIN OUR TEAM APPLICANT INFORMATIONLast Name(Required) First(Required) M.I. Date MM slash DD slash YYYY Address Street Address City State / Province / Region ZIP / Postal Code Apartment/Unit # PhoneEmail(Required) Date Available MM slash DD slash YYYY Social Security No. Desired Salary Position Applied for Are you a citizen of the United States? Yes No If no, are you authorized to work in the U.S.? Yes No Have you ever worked for this company? Yes No If so, when? Were you referred to this company by a current or former employee? Yes No If yes, who? How did you hear about our company? EDUCATIONHigh School Address Street Address From MM slash DD slash YYYY To MM slash DD slash YYYY Did you graduate? Yes No Degree College Address Street Address From MM slash DD slash YYYY To MM slash DD slash YYYY Did you graduate? Yes No Degree Other Address Street Address From MM slash DD slash YYYY To MM slash DD slash YYYY Did you graduate? Yes No Degree REFERENCES Please list three professional references.Full Name First Relationship Company PhoneAddress Street Address Full Name First Relationship Company PhoneAddress Street Address Full Name First Relationship Company PhoneAddress Street Address PREVIOUS EMPLOYMENT – LAST SEVEN YEARS (LIST MOST RECENT FIRST) Most Recent Company PhoneAddress Street Address Supervisor Job Title Starting Salary $Ending Salary $Responsibilities From MM slash DD slash YYYY To MM slash DD slash YYYY Reason for Leaving May we contact your previous supervisor fora reference? Yes No Company PhoneAddress Street Address Supervisor Job Title Starting Salary $Ending Salary $Responsibilities From MM slash DD slash YYYY To MM slash DD slash YYYY Reason for Leaving May we contact your previous supervisor fora reference? Yes No Company PhoneAddress Street Address Supervisor Job Title Starting Salary $Ending Salary $Responsibilities From MM slash DD slash YYYY To MM slash DD slash YYYY Reason for Leaving May we contact your previous supervisor fora reference? Yes No Branch From MM slash DD slash YYYY To MM slash DD slash YYYY Rank at Discharge Type of Discharge If other than honorable, explain EMPLOYMENT INFORMATIONWhen are you available to start work? Desired Employment Type Full-Time Part-Time Desired Salary (Per Hour) What is your ideal position and work schedule?What are your long-term career goals?Are you available to work overtime? Yes No Are you available to work weekends? Yes No Do you have a valid driver’s license? Yes No If yes, please provide license number and state: Will you be able to perform the essential job functions for the position you are applying, either with or without reasonable accommodations? Yes No BACKGROUND DATAOur company may conducta criminal records investigation. A conviction on your record may not necessarily bar you from employment with our company. Have you ever been convicted of a felony? Yes No If yes, explainIf yes, explainAre you currently out on bail or released on your own recognizance pending trial? Yes No If yes, explainKNOWLEDGE AND SKILLSPlease rate your skills and knowledgefrom 1-3 in each of the following areas: (1 is no experienceand 3 is expert– not all areas may apply)Air Conditioning – CommercialAir Conditioning – ResidentialRefrigerationCommercial Kitchen RepairHeatingElectricalEnergy Management SystemsPreventative MaintenanceDispatchBidding/Cost Estimation (HVAC)Electronic Dispatch SoftwareSalesCertifications and Licenses:List equipment brands you are familiar working on:List your three top areas of expertise (e.g., refrigeration, commercial HVAC, chillers, etc):List any computer or dispatch software you are familiar with:Have you ever worked with or used electronic handheld devices to invoice customers and track equipment? Yes No ADDITIONAL INFORMATION, DISCLAIMER AND SIGNATUREPersons with Disabilities/Vietnam Veterans, Disabled Veterans and Other Covered Veterans The Americans with Disabilities Act (ADA) and Section 503 of the Rehabilitation Act of 1973 prohibit employment discrimination against qualified individuals with disabilities. Section 402 of the Vietnam Era Veterans Readjustment Assistance Act of 1974, as amended by the Veterans Employment Opportunity Act of 1998, eliminates barriers of employment for veterans. Our companies willingly comply with these laws. Application Information Please read the following statements and ask for clarification, if needed, before you sign this application. Applicants will be considered regardless of race, color, religion, gender, national origin, citizenship status, sexual orientation, age, marital status, veteran status, or the presence of a medical condition or disability. I certify that my answers are true and complete to the best of my knowledge. Further, I understand that if hired, I agree to abide by all company policies and procedures, as outlined in the company handbook. If this application leads to employment, I further understand that false or misleading information in my application or interview may result in my release, regardless of how or when it was discovered. I authorize United Service Network, LLC, and/or it’s subsidiaries to investigate and verify all statements and information contained in this application and during my interview (if applicable). I release all liability from anyone supplying such information, as well as United Service Network, LLC, and it’s subsidiaries from any and all liability that might result from conducting an investigation. If hired, I further understand that: My employment would be at will, and that I could be terminated at any time, with or without cause or notice at the option of the employer or myself. This employment application will become part of the terms and conditions of employment.Signature Date MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.