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7/28/2019 New Hire App
1/5
PLEASEPRINTALLINFORMATION EQUESTEDEXCEPTSIGNATURE
Integrity Heat& Ai r LLG
APPLICATION OR EMPLOYMENTAPPLICANTSMAY BE TESTEDFO R LLEGALDRUGS
PLEASECOMPLETEPAGES1-5.
Presentaddress
Ho w on gCitY State
Social ecuritYo.Telephone )lf under18,please is tag e
Days/hours vailableo workPosit ion ppliedor (1 ) NoPref - Thurand salarydesired (2)(Be specific)
Mon- FriTue - Sat
HowmanyhourscanYouworkweeklY? Ca nyo uwork nights?Employment esired trFULL-TIMEONLYWhenavailableor work?-
OPART-TIME NL Y trFULL. OR PART-TIME
TYPEOF SCHOOL NAMEOF SCHOOL LOCATION(Completemailingaddress)
NUMBEROF YEARSCOMPLETEDMAJOR&DEGREE
HiohSchoolCollegeBus. rTrade choolProfessional chool
HAVEYOUEVERBEENCONVICTEDOFA CRIME? t rNo D Yeslf yes,explain umber f conviction(s),ature f offense(s)eadingo conviction(s),ow ecentlyuchoffense(s) as/werecommitted,entence(s)mposed, nd ype(s) f rehabilitation'
7/28/2019 New Hire App
2/5
PLEASE RINT LLINFORMATIONEQUESTEDEXCEPT IGNATURE APPLICATION OR EMPLOYMENT
DOYOUHAVE DRIVER'SICENSE? tr Yes tr NoWhat s your meansof transportationo work?Driver's icensenumber Stateof issue E Operator E Commercial CDL)DChauffeurExpiration ateHaveyou hadany accidentsduring he past hreeyears? Ho wmany?Ho wMany?Haveyou hadanYmovinguiol"tio@
OFFICEONLY
E YesTyping D No
E Yes Word tr YesWpM 10-key tr No Processing tr No -WPM
Personal E Yes PC tr OtherSkillsComputer tr No Mac trplease ist wo references ther han relatives r previousemployers'
NamePosition PositionCompanyAddress
CompanyAddress
Telephone ( ) Telephone
An applicationormsometimesmakes t difficult or an individualo adequately ummarizea completebackground' Use hespacebelow o summarizeany additionatntormation ecessaryo describe our full qualificationsor the specificposition orwhichyou are aPPlYing.
7/28/2019 New Hire App
3/5
PLEASE RINT LLINFORMATIONEQUESTEDEXCEPT IGNATUREAPPLICATION OR EMPLOYMENT
MILITARY
HAVE OUEVER EENNTH EARMED ORCES? E Yes tr NoA R E Y o U N o W A M E M B E R o F T H E N A T | o N A L G U A R D ? E l Y e s B N o
Date Entered DischargeDate
WorkExperience Pleaseistyourworkexperienceor hepastfiveyearsbeginning ithyourmost ecentobheld'ii yo, *"r"'r"lf-employed, ive irmname. Attachadditional heets f necessary'
Nameof emPloYerAddressCity,State,ZiP CodePhonenumber
Your ast ob titleReason or leaving be sPecific)List he obs you held,dutiesperformed, killsusedor learned,advancements r promotionswhileyou workedat this
Nameof emPloYerAddressCity,State,ZiPCodePhonenumber
YourLast obTitleReason or leaving be sPecific)List he obs you he|d,dutiesperformed, ki||susedor |earned, dvancements r promotionswhi|eyou workedat this
7/28/2019 New Hire App
4/5
PLEASEPRINTALLINFORMATION EQUESTEDEXCEPTSIGNATUREAPPLICATION OR EMPLOYMENT
WorkPleasel is tyourworkexper iencefor thepast f iveY"" t " . lgs l ! l ' lp -y l ' l lY : : : l : " :ent jobheld 'experience rtyouweil'sell-"tpby;d, giNameof emPloYerAddressCity,State,ZiPCodePhonenumber
Your ast ob titleReason or leaving be sPeciflc)List he obs you held,dutiesperformed, killsusedor learned,advancements r promotionswhileyou workedat this
Name femPloYerAddressCity,State, iPCodePhone umber
Your as tob itleReason or leaving be sPecific)List he obs you held,dutiesperformed, killsusedor learned,advancements r promotionswhileyou workedat this
Maywe contactyour presentemployer?Didyou complete his application ourself
O Yes tl NoEYes tr No
lf not,wh odid?
7/28/2019 New Hire App
5/5
PLEASEREADCAREFULLY
APPLICATIONFORMWAIVER
Inexchangeor heconsiderationfmy obapplicationyCompany"),agreehat:
employment,r o confer ny ight o remain n employeef
Neitherheacceptancef hisapplicationor hesubsequentntryntoany ypeof employmentrelationship,ithern heposition'appliedor or anyother osition,nd egardlessf heconlents femployeeandbooks,eisonnel anuals,enefit lans, olicy tatements,nd he ikeas heymayexistfrom ime o ime,or otherCompany ractices,hall erveocreate nactual r mplied ontract f
(hereinafteralled th e
or otherwise o"nJng6 in any respect he empl6yment-at-willelationship etween t and the undersigned,
nd thatrelati[nsnip annot be altered'exieptby a written nstrument ignedby the PresidentGeneralManageroft heComp i ny . Bo t h theunde rs i gnbodna__may .end t heemp loymen t re |a ti onsh ipa tu"y ii.-, withoutspecifred oticior reason.- |f ernployed, understandhat he Companymay unilaterally-f1lng" or revise heirbenefits,policiesand procedures nd suchchangesmay include eduction nbenefits.I authorizenvestigation f all statements ontained n this application. I understandhat themisrepresentationr omissionof factscalled or is cause or dismissalat any time withoutany previous;;ti";. I herebygive he Companypermission o contactschools,previousemployers unlessotherwiseindicated), eferences, nd othirs, and hereby elease he Company rom any liabilityas a resultof suchcontract.I alsounderstandha t 1) he Company as a drugan dalcohol olicy ha tprovidesor preemploymentteiting as well as testirig'att"r"rdioy,ir"nt; (2) co-nsento and compiiancewith such policy s a condition
ofmy eilptoyment;and (3j continue'd inpfoyniehts basedon the successful assingof testingundersuchpo5"y.' I furtherundeisiand hat continuedemploymentmaybe basedon the successfulpassingofjob-related hysicalexaminations.I understandhat, n connection it h he routine rocessing f youremployment pplication,he companymay request rom a consumer eportingagencyan investigative onsumer eport ncluding nformation s to.y "reO'itrecords, naracter, eneral 6pu'iation, ersonaliharacteristics,
nd mode of living. Uponwritten,"tfr"rt from me, n" Comp"'iy, will provideme with additionalnformation oncerning he natureand scopeof any such report equestbO y it, as requiredby the FairCreditReportingAct.I furtherunderstandhat my employmentwith the Companyshallbe.probationaryor a periodof sixty(60)days,and urther hat at any tim'eduring he probationary eriodor thereafter,my employment elationwithtne ompany is terminableat will for any reasonby eitherparty'
Signature f apPlicant Date:
Thiscompanys anequalemploymentpportunitymployer.we adhereo a policy fmakingemploymentecisions ithoutegardo race, otor,eligion,ex,sexual rientation,ational rigin'citizenship,geor OisaOiiity.W""u"rur"you hatyouropportunityoremployment ith hisCompanydependsolely nyour ualifications.
Thankyou for completing his applicationorm and or your nterest n our business'