Career Application - Calcasieu Mechanical Contractors, Inc.

Application For Employment

Please fill out form completely for employment consideration. Prospective employees will recive consideration without discrimination because of race, creed, color, sex, age, national origin or handicap. We are an equal opportunity employer

PERSONAL INFORMATION

Name*

First Name Middle Name Last Name

Date

Street Address*

Street Address

Home Phone

City

State

Zip

Business Phone

Email Address*

How long at present address? (Years & Month)

Years Month

Are you 18 years of age?

Yes
No

If not, employment is subject to verification of minimum legal age.

Have you ever applied for employment with us?

Yes
No

If Yes: Month and Year

Location

What position are you applying for?*

Social Security No

How did you learn of our organization?

Are you legally eligible for employment In the United States?

When will you be able to work ?

Are you employed now?

If so, may we inquire of your present employer?

Have you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been anulled, expunged, or sealed by the court?

Yes
No

If Yes, Describe in full.

Are there any reasons for which you might not be able to perform the job duties (with a reasonable accomodation)?

Yes
No

If Yes, Please explain.

#Driver License

State

Any Violations?

Yes
No

EDUCATION

College

Name and Location

Course

No. of years completed

Did you graduate?

Yes
No

Degree or diploma

High School

Name and Location

Course

No. of years completed

Did you graduate?

Yes
No

Degree or diploma

Trade School

Name and Location

Course

No. of years completed

Did you graduate?

Yes
No

Degree or diploma

Other

Name and Location

Course

No. of years completed

Did you graduate?

Yes
No

Degree or diploma

MILITARY

Complete this section if you served in the U.S. Armed Forces

Branch Of Service

Describe your duties and any special training

Period of Active Duty (Month & Year) (From & To)

From To

Rank at Discharge

Date of Final Discharge

EMPLOYMENT HISTORY

Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer

#1

Company Name

Telephone

Address

Street Address

Employed (Start Month and Year) (From & To)

From To

Name of Supervisor

Hourly Rate (Start & Last)

Start Last

Start Job Title and Describe Your Work

Reason For Leaving

#2

Company Name

Telephone

Address

Street Address

Employed (Start Month and Year) (From & To)

From To

Name of Supervisor

Hourly Rate (Start & Last)

Start Last

Start Job Title and Describe Your Work

Reason For Leaving

#3

Company Name

Telephone

Address

Street Address

Employed (Start Month and Year) (From & To)

From To

Name of Supervisor

Hourly Rate (Start & Last)

Start Last

Start Job Title and Describe Your Work

Reason For Leaving

#4

Company Name

Telephone

Address

Street Address

Employed (Start Month and Year) (From & To)

From To

Name of Supervisor

Hourly Rate (Start & Last)

Start Last

Start Job Title and Describe Your Work

Reason For Leaving

We may contact the employers listed above unless you indicate those you do not want us to contact

Do Not Contact

Employer Number(s)

Reason

REFERENCES

Give below the names of three persons not related to you, whom you have known for at least one year.

#1

Name

First

Address

Street Address

Business

Years Acquainted

#2

Name

First

Address

Street Address

Business

Years Acquainted

#3

Name

First

Address

Street Address

Business

Years Acquainted

The information provided in this Application for Employment is true, Coorect and complete. If employed, any misstatements or omissions of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and peronal history, I authorize you to do so. If a report is obtained you must provide, at my request, the name and address of the agancy so I may obtain from them the nature and substance of the information contained in the report.

Date