How did you hear about LaSalle Heating and Air Conditioning, Inc.?
What skills, experience, and/or knowledge do you have that will help you in the HVAC industry?
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A. Personal Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Are you legally eligible for employment in the USA?
Yes
No
Position Applying For:
Date Available For Employment:
Employment Desired:
Full-Time
Part-Time / Seasonal
Full OR Part-Time
Are you available to work over-time?
Yes
No
Are you willing to travel?
Yes
No
Do you have a valid driver's license in this state?
Yes
No
Driver's License Number:
Expiration Date:
-
Month
-
Day
Year
Date
License Type:
CDL/Class A
Class B
Class C
Class D
List any friends/relatives who are employed with us:
B: Education
Rows
Name of School
Location
Number of Years
Completed
Major & Degree
High School
College
Bus./Trade
Professional
Summarize special skills and qualifications, volunteer activities, military experience or awards received:
C. Employment History (Most recent first)
Employer 1:
Name of Employer:
Employer Address:
(City, State, Zip Code)
Supervisors Name
Supervisor Phone Number
(City, State, Zip Code)
Employment Start Date
-
Month
-
Day
Year
Date
Employment End Date
-
Month
-
Day
Year
Date
Starting Salary
End Salary
Job Titles:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company
Employer 2:
Name of Employer:
Employer Address:
(City, State, Zip Code)
Supervisors Name
Supervisor Phone Number
(City, State, Zip Code)
Employment Start Date
-
Month
-
Day
Year
Date
Employment End Date
-
Month
-
Day
Year
Date
Starting Salary
End Salary
Job Titles:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company
Employer 3:
Name of Employer:
Employer Address:
(City, State, Zip Code)
Supervisors Name
Supervisor Phone Number
(City, State, Zip Code)
Employment Start Date
-
Month
-
Day
Year
Date
Employment End Date
-
Month
-
Day
Year
Date
Starting Salary
End Salary
Job Titles:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company
Employer 4:
Name of Employer:
Employer Address:
(City, State, Zip Code)
Supervisors Name
Supervisor Phone Number
(City, State, Zip Code)
Employment Start Date
-
Month
-
Day
Year
Date
Employment End Date
-
Month
-
Day
Year
Date
Starting Salary
End Salary
Job Titles:
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company
D. References (Only individuals familiar with your work ability. Do not include relatives.)
Rows
Name:
City, State
Phone Number:
Years Known:
Relationship:
1
2
3
4
E. Background
Have you ever been convicted of a misdemeanor, gross misdemeanor or felony crime?
Yes
No
If yes, please explain the nature of the offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.
F: Signature and Agreement
I certify that to the best of my knowledge and belief, the information provided in order to complete this applicationis true, complete and accurate. I understand that false statements or omissions on this application may resultin rejection of my application or, if employed, may result in my discharge at any time.
I authorize investigation of all statements covered herein. I further authorize all individuals, companies, schools,corporations, courts and law enforcement agencies to give LaSalle Heating and Air Conditioning any and all informationconcerning my previous employment and any pertinent information they may have, personal or otherwise. I releaseall parties from all liability for any damage that may result from giving this information.
I understand, if hired, that I am employed at will and that my employment and compensation can be terminated withor without cause, and with or without notice, at any time either by myself or by LaSalle Heating and Air Conditioning
I realize that under certain state or federal laws, I may be required to submit to an alcohol and/or drug test as acondition of my employment. I hereby agree to submit to such an examination if required to do so by companypolicy and permit disclosure of results to LaSalle Heating and Air Conditioning .
Please Sign
(We know it will be messy if you are using a mouse)
Date
-
Month
-
Day
Year
Date
Submit
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