Please fill out the following form. When finished, click Submit Application or to reset the form, click Clear Form:

APPLICATION

Full Name:

Street or P.O. Box:

City:

  State:    Zip Code:  

Phone:

  Social Security No:  

Email Address:

Position applied for:

Are you at least eighteen years of age?:   Yes     No

Are you legally eligible to work in the United States?:   Yes     No

Have you ever been convicted of a crime other than a misdemeanor?   Yes     no

Date of Availability for work:

  ex: 5-20-2005

Full Time or Part Time:

How did you hear about us?

Salary Requirements

EDUCATION
Name and Location of School

High School:

Did you graduate?

  Yes     No

College or University

Did you graduate?

  Yes    No

Advanced Degree:

Did you graduate?

  Yes     No

WORK HISTORY
Begin with most recent position

1.

Company Name:

Address:

Telephone:

Date Employed (month & year)

 ex: 5/1997-12/2004

Name of Supervisor:

Job Title:

Description of duties & responsibilities:

Starting Pay:

Ending Pay:

Reason for leaving:

Are you eligible for rehire with this firm?

  Yes     No

2.

Company Name:

Address:

Telephone:

Date Employed (month & year)

ex: 5/1997-12/2004

Name of Supervisor:

Job Title:

Description of duties & responsibilities:

Starting Pay:

Ending Pay:

Reason for leaving:

Are you eligible for rehire with this firm?

 Yes     No

3.

Company Name:

Address:

Telephone:

Date Employed (month & year)

ex: 5/1997-12/2004

Name of Supervisor:

Job Title:

Description of duties & responsibilities:

Starting Pay:

Ending Pay:

Reason for leaving:

Are you eligible for rehire with this firm?

 Yes     No

4.

Company Name:

Address:

Telephone

Date Employed (month & year)

ex: 5/1997-12/2004

Name of Supervisor:

Job Title:

Description of duties & responsibilities:

Starting Pay:

Ending Pay:

Reason for leaving:

Are you eligible for rehire with this firm?

 Yes     No

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

DO NOT CONTACT:

Employer Name: 

Reason: 

Employer Name: 

Reason: 

REFERENCES:
Please indicate business references which High Rise Fire Protection Corp. may contact:

Name:

Business:

Working relationship with you:

Phone Number:

Name:

Business

Working relationship with you:

Phone Number:

Name:

Business

Working relationship with you:

Phone Number:

SPECIAL SKILLS:

Please list the computer software programs you are capable of operating:

Please list any other special skills, training, or experience you would like us to know about:

SIGNATURE:

I certify that answers given herein are true and complete.

I authorize investigation of all statements in this application for employment as may be necessary in arriving at any employment decision. I understand that this application is not and is not intended to be a contract of employment. If employed, I may terminate employment at any time for any reason, and the Company may terminate my employment at any time for any reason.

If employment is obtained and it is discovered that false or misleading information has been given in my application or interview(s), I understand that this may result in discharge.

Signed:       Dates:    ex:2-12-2005
 

High Rise Fire Protection Corp. is an equal opportunity employer.