Application for Employment Step 1 of 5 20% Equal Access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department. First Name:*Middle Name:Last Name:*Street Address:City:State:Zip Code:Country:Phone Number:*Alternate Phone Number:Email Address:* If necessary, best time to call you at is…AMPMMay we contact you at work?YesNoWork Phone Number:Best Time to Call:Position(s) applied for: Account Receivable Associate Customer Service Representative Commercial Service Dispatcher Commercial HVAC Duct Foremen (Orlando and Tampa) Commercial HVAC Sheet Metal/Fiberglass Foreman Commercial HVAC Service and Controls Technician Commercial HVAC Plumbing Foreman Commercial HVAC Plumbing Mechanic Residential HVAC Lead Service Technician Residential HVAC Service Technicians (Orlando, Tampa, & Melbourne Areas) Residential HVAC Duct and Equipment Installers Warehouse HVAC Sheet Metal/Fiberglass Mechanic Other Please Enter Desired Position:Referral Source:SchoolEmployeeJob FairAdvertisementStaffing AgencyGovernment AgencyWebsite Type of employment desired: Full-Time Part-Time Educational Co-Op Seasonal Temporary Date available to work:* What is your desired salary range or hourly rate of pay?HourlyMonthlyAnnuallyHave you submitted an application before?YesNoHave you ever been employed here before?YesNoFrom To If you are under 18, and it is required, can you furnish a work permit?YesNoIf No, please explain:Are you legally eligible for employment in this country?YesNo If it has been explained, are you able to meet the attendance requirements of the position?YesNoN/AEnergy Air employees regularly commute, on an average, 60 miles to a job site. If hired, will you commit to this regular & daily commute?YesNoIf driving is a required function of the job for which you are applying, please provide driver’s license number:License #:State:Do you have reliable transportation?YesNoWill you work overtime if the job requires it?YesNoWill you work overtime on? Days Weekends Nights Will you work Night Shift if the job requires it?YesNoWill you relocate if the job requires it?YesNoAre you willing to be fit tested to wear a respirator if the job requires it?YesNoAnswering “Yes” to the following question does not constitute an automatic bar to employment. Factors such as date of the of-fense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. Have you ever plead “guilty” or “no contest” to, or been convicted of a crime?YesNoPlease provide the following Information: date/dates of conviction(s), penalty/penalties imposed, and type(s) of crime(s). Employment History Starting with your most recent employer, provide the following information. Employer:Phone Number:City:State:Starting job title /final job title:Dates Employed:From To Compensation (Starting):HourlySalaryCommission/Bonus/Other:Immediate supervisor and title (for most recent position held):Why did you leave?May we contact for reference?YesNoLaterSummarize the type of work performed and job responsibilities.What did you like most about your position?What were the things you liked least about the position? Employer:Phone Number:City:State:Starting job title /final job title:Dates Employed:From To Compensation (Starting): Hourly Salary Commission/Bonus/Other:Immediate supervisor and title (for most recent position held):Why did you leave?May we contact for reference?YesNoLaterSummarize the type of work performed and job responsibilities.What did you like most about your position?What were the things you liked least about the position? Employer:Phone Number:City:State:Starting job title /final job title:Dates Employed:From To Compensation (Starting): Hourly Salary Commission/Bonus/Other:Immediate supervisor and title (for most recent position held):Why did you leave?May we contact for reference?YesNoLaterSummarize the type of work performed and job responsibilities.What did you like most about your position?What were the things you liked least about the position? Explain any gaps in your employment, other than those due to personal illness, injury or disability:If not addressed above, have you ever been fired or asked to resign from a job?YesNoPlease explain: Skills and Qualifications Summarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying. Educational Background Start with your most recent school attended, provide the following information. School:*(include City & State) Years Completed:DiplomaGEDDegreeCertificateGPA / Class Rank:Major/Minor:Upload Resume If DesiredAccepted file types: pdf. Second School:(include City & State) Years Completed:DiplomaGEDDegreeCertificateGPA / Class Rank:Major/Minor: Third School:(include City & State) Years Completed:DiplomaGEDDegreeCertificateGPA / Class Rank:Major/Minor:References List name and telephone number of three business/work references who are NOT related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you. First ReferenceFirst Name:Last Name:Title:Relationship to You:Years Known:Phone Number: Second ReferenceFirst Name:Last Name:Title:Relationship to You:Years Known:Phone Number: Third ReferenceFirst Name:Last Name:Title:Relationship to You:Years Known:Phone Number: Related Information To what job-related organizations (professional, trade, etc.) do you belong? Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veterans/reserve national guard or any other similarly protected status. Organization:Offices Held:Organization:Offices Held:Organization:Offices Held:Is there any other job related information you want us to know about you? Applicant Statement I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional) , employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. I understand that if I am hired, my employment will be subject to a probationary period, which ordinarily will not exceed 90 days from the date I am hired. If I am discharged at any time during the probationary period for unsatisfactory performance, I understand the employer will not be charged for any unemployment benefits that may be paid to me for work I performed during the probationary period. I understand that if I am hired, this job will be my primary job and any secondary employment may not interfere with scheduling demands per the employer’s policy on outside employment. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 form in this regard. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any aspect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service whenever it is discovered. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.* I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement. Δ AN EQUAL OPPORTUNITY EMPLOYER
