Employment Application

We are always looking for talented individuals to join our team. If you think you might be a good fit, please complete our employment form.

Application For Employment

It is our policy to accept applications when openings exist. Your application will remain active for 3 weeks. If you are not hired for the current opening, you may re-apply when another opening exists.

Position applied for:

Date Available:

Date:

Available for:

Full-timePart-timeTemporary

If part-time, specify hours/days:

Will you work weekends?

YesNo

Will you work substantial overtime?

YesNo

Will you work any shift?

YesNo

Last Name:*

Middle Name:

First Name:*

Date:

Street:*

City:*

State:*

Zip:*

Phone:*

Email:*

Are you at least 18 years of age?

YesNo

Referral Source:

WebsiteAn employeeEmployment agencyOther

If Other Refrerral Source:

Are you legally authorized to work in the United States? (all U.S. citizens are authorized; non-citizens require specific work authorization by the U.S. Government)

YesNo

Highest level of college education completed:

1234

Name and address of last educational institution attended:

List any certifications, degrees or special training you have received:

Have you served in the United States Military?

YesNo

If yes, what Branch?

Date discharged:

Special training?

Have you applied here before?

YesNo

If yes,when?

Have you ever been disciplined or fired?

YesNo

If yes,please explain

You have read over and understand the job requirements and are able to perform all of the essential functions of the job for which you are applying?

YesNoDon't know

If “No” or “Don’t know”, please explain:

*Your response to these questions will not necessarily have any affect on your chances for employment. Only job-related factors will be taken into account.

(List present or most recent job first)

Employer 1

Employer:

Street:

City:

State:

Zip:

Supervisor:

Phone:

Job Title:

Duties:

Date Employed (Start – End):

Start:

End:

Reason for leaving:

Employer 2

Employer:

Street:

City:

State:

Zip:

Supervisor:

Phone:

Job Title:

Duties:

Date Employed (Start – End):

Start:

End:

Reason for leaving:

Employer 3

Employer:

Street:

City:

State:

Zip:

Supervisor:

Phone:

Job Title:

Duties:

Date Employed (Start – End):

Start:

End:

Reason for leaving:

Employer 4

Employer:

Street:

City:

State:

Zip:

Supervisor:

Phone:

Job Title:

Duties:

Date Employed (Start – End):

Start:

End:

Reason for leaving:

List any other employers and/or periods of unemployment during the past five (5) years:

I understand that this application and any attachment are the property of this Corporation. I certify that the statements made by me in this application are true, complete and correct. I hereby grant this Corporation permission to verify the information provided. I understand that any false statement on this application may cause rejection of this application, or dismissal if such false statement is discovered subsequent to my employment. I hereby authorize my present and previous employers and educational institutions to provide the Corporation with any and all legally disclosing information concerning my previous employment and education, and I expressly waive any right to receive written notice of the provision of such information. I agree to hold my present and previous employers and educational institutions and their agents harmless for releasing such information. I understand that any offer of employment is dependent upon my satisfactorily passing a physical examination and/or the associated laboratory tests (including drug and alcohol tests) that may be prescribed by the Corporation. Any offer of employment is based upon my agreement to abide by the rules and regulations of this Corporation and its subsidiaries, as the Corporation determines or changes from time to time.

I understand that any employment obtained with the Corporation shall be at such wages, benefits,hours and conditions as the Corporation may determine and change from time to time. Such employment shall be for no definite term and can be terminated by the Corporation at any time, with or without cause, and with or without notice, regardless of the date or period of payment, wages or salary and regardless of any contrary provisions in any other forms, manuals, handbooks, etc. I understand that no one other than the President of the Corporation has any authority to enter into any agreement for employment for a specified period of time or to make any agreement which is contrary in any way to the foregoing and that any such agreement must be in writing and personally signed by me and the President of the Corporation or it shall not be binding.

Signature:

This application will remain active for a period of three (3) weeks from the date of completion. Should you wish to reactivate your application at the end of this three (3) week period, please notify this office in writing at that time.

It is the policy of Seaman’s Air Conditioning & Refrigeration, Inc. to implement affirmatively equal opportunity to all qualified employees and applicants for employment without regard to race, color, religion, sex, age, national origin, disability, height, weight, marital status, or other prohibited factors.

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