Application for employment

Which department would you like to apply for?

Tell us about yourself.

Your Name *

Date Of Birth *

Email Address *

Street Address *

City *

State *

Zip Code *

Phone Number *

Alternate Phone Number

Best time to call

Position you are applying for:

If hired, when can you start?

What is your desired wage?

Are you willing to sign a 1 year contract? YesNo

Do you have a valid driver's license? YesNo

Is there anything on your driving record in the last 3 years that may prevent us from allowing you to drive company vehicles?
YesNo

How did you hear about us?

If referred, whom can we thank?

Are you a US citizen or otherwise authorized to work in the US on an unrestricted basis?
(You may be required to provide documentation.)

YesNo

Are you seeking full time employment?

YesNo

Have you ever been convicted of a felony?
(This will not necessarily affect your potential for employment.)

YesNo

Tell us about your education.

What high school did you attend?

Did you graduate? YesNo

College Name if applicable:

Did you graduate? YesNo

College Major

Tell us about your employment history.

Most Recent Company Name

May we contact this employer?
YesNo

Date Started:

Date Ended:

Why did you leave this company?

Please tell us about one other previous job.

Previous Company Name

May we contact this employer?
YesNo

Date Started:

Date Ended:

Why did you leave this company?

Special Skills

Tell us about your work experience.
If you are applying for an office position, you are not required to fill out this section.

Please rate yourself as to the knowledge that you have on each of the following subjects.
One(1) is no knowledge and Ten(10) is expertise in the given subject.

Plumbing

Heating / Oil

Heating / Gas

Heating / Coal

Heating / Electrical

Heating / Wood

Electric / Wiring To Code

Electric / Conduit

Electrical / Service Installation

A/C Commercial

A/C Residential

Refrigeration / Residential

Refrigeration / Commercial

By submitting this application, you agree that the facts set forth in this application for employment are true and complete to the best of your knowledge.

You understand that if you are employed, false statements on this application shall be considered sufficient cause for dismissal.

Danny Larcom Heating & Air, Inc. is here by authorized to make any investigation of your prior educational history and employment history.

I AgreeI Disagree

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