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EMPLOYMENT APPLICATION FORM
PERSONAL INFORMATION
NAME (LAST, FIRST)
PHONE NUMBER
DATE
CURRENT ADRESS
PERMANENT ADRESS
DOB
SOCIAL SECURITY NUMBER at the time of interview
Citizenship/Work Status:
U.S. Citizen
Green Card Holder
U.S. Work Permit/Visa
Canadian Citizen
CanadianWork Permit/Visa
Current Employer:(if Any)
RECOMMENDED BY:
POSITION INTERESTED IN
POSITION NAME
SALARY/ DESIRED SALARY
DATE YOU CAN START
ARE YOU CURRENTLY EMPLOYED?
YES
NO
IF YOU APPLY, CAN WE CONTACT YOUR PRIOR EMPLOYEES?
YES
NO
ARE YOU IN GOOD HEALTH CONDITIONS?
YES
NO
HAVE YOU EVER SUBMITED AN APPLICATION TO THIS COMPANY BEFORE?
YES
NO
LOW VOLTAGE SKILLS
What types of systems have you worked with?(Select all that apply)
Wiring:
Low Voltage System
Automation System
Audio Video
Lighting Control System
Shades
CCTV
Security
Access Control
Network/Data
AV Racks
Fire Alarm Systems
Others
Installation:
Automation System
Audio Video
Lighting Control System
Shades
CCTV
Security
Access Control
Network/Data
AV Racks
Phone System
Fire Alarm Systems
Others
Programming:
Automation System
Audio Video
Lighting Control System
Shades
CCTV
Security
Access Control
Network
Phone System
Fire Alarm Systems
Others
EDUCATION
HIGH SCHOOL
NAME OF THE SCHOOL
DATES
GRADUATED
SUBJECT STUDIED
NAME OF THE SCHOOL
DATES
GRADUATED
SUBJECT STUDIED
TRADE SCHOOL / COLLEGE / UNIVERSITY
NAME OF THE SCHOOL
DATES
GRADUATED
SUBJECT STUDIED
NAME OF THE SCHOOL
DATES
GRADUATED
SUBJECT STUDIED
NAME OF THE SCHOOL
DATES
GRADUATED
SUBJECT STUDIED
PREVIOUS EMPLOYMENT
DATE/MONTH/YEAR
FROM
TO
NAME AND ADDRESS OF PREVIOUS EMPLOYER
COMPANY NAME
CITY
STATE
ZIP
FINAL SALARY
POSITION
REASON FOR LEAVING
DATE/MONTH/YEAR
FROM
TO
NAME AND ADDRESS OF PREVIOUS EMPLOYER
COMPANY NAME
CITY
STATE
ZIP
FINAL SALARY
POSITION
REASON FOR LEAVING
DATE/MONTH/YEAR
FROM
TO
NAME AND ADDRESS OF PREVIOUS EMPLOYER
COMPANY NAME
CITY
STATE
ZIP
FINAL SALARY
POSITION
REASON FOR LEAVING
CRIMINAL HISTORY
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR (except any minor traffic violationes)?
YES
NO
If yes, please explain and attach any relevant documentation
DRIVERS LICENSE INFORMATION
DO YOU HAVE A VALID DRIVER'S LICENSE?
YES
NO
Do you have reliable transportation to work (please be specific)?
YES
NO
Driver's license number:
Operator
Commercial (CDL)
Chauffeur
State of Issue:
Do you have a clean driving record?
YES
NO
List any Moving Violations and/or Accidents from the last 3 years:
MILITARY SERVICE
HAVE TOU EVER BEEN IN THE ARMED FORCES?
YES
NO
Branch:
ARE YOU CURRENTLY A MEMBER OF THE NATIONAL GUARD OR RESERVES?
YES
NO
Specialty
Date Entered
Discharge Date
PROFESSIONAL REFERENCES
Please list 3-4 people you have worked with who can attest to your On-the-Job experience and performance.
NAME
POSITION
COMPANY
TELEPHONE
EMAIL ADDRESS
NAME
POSITION
COMPANY
TELEPHONE
EMAIL ADDRESS
NAME
POSITION
COMPANY
TELEPHONE
EMAIL ADDRESS
NAME
POSITION
COMPANY
TELEPHONE
EMAIL ADDRESS
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