A1 Air Vent Employment Application

Mial Application to: A1 Airvent
P.O. Box 405
Loomis, CA  95659-0405



Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for the application interview.

Date of Interview (Month/Day/Year):

Applicant Data

Position Applied for:

How you were referred to us:

 

Full Name:

 

Address:                                                 City:                                         State:                       Zip:

 

Phone:                                                                     Mobile/Pager/Other:                 E-mail:

 

Date Available to Start:                                           Social Security Number:                                          Salary Requirements:

 

If you are under 18 years of age, can you provide a work permit?  Yes   No   If no, please explain:

 

 

Have you ever worked for this company?  Yes  No                      If yes, when?

 

 

 

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

 

Type of employment desired: Full-Time Part-Time  Temporary  Seasonal

 

Have you ever pleaded guilty, no contest or been convicted of a crime?   Yes No___If yes, give dates and details:

 

 

 

 

 Answering yes to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

 

 

Driver's license number (if applicable to position):                                                                 State:

 

 

Summarize your skills of Qualifications

 

 

 

 

 

 

 

 

 

Dates of Employment:     From____/____ /____             To____/____/____     Position(s)Held:__________________________________

 

 

 

 

 

 

 

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Socrates Media LLCHR104

 

 

Previous Employment Record (begin with most recent position)

 

 

Company Name:                                                                                               Address:

 

City:                                                                                      State:                                        Zip:

 

Phone:                                                               Supervisor:                                 Title:

 

Responsibilities:



 

Starting Salary and Title:                                                      Ending Salary and Title:

 

Reason for Leaving:

 

 

May we contact this employer for a reference?  Yes   No

 


Dates of Employment:   From____/____/____                      To____/____/____                  Position(s) Held:__________________________

Company Name:                                                                                    Address:

 

City:                                                                State:                                         Zip:

 

Phone:                                                  Supervisor:                                  Title:

 

Responsibilities:

 

 

 

Starting Salary and Title:                             Ending Salary and Title:

 

Reason for Leaving:

 

 

May we contact this employer for a reference? Yes   No

 


Dates of Employment:   From____/____/____                      To____/____/____                  Position(s) Held:_________________________

Company Name:                                                                                    Address:

 

City:                                                                State:                                         Zip:

 

Phone:                                                  Supervisor:                                  Title:

 

Responsibilities:

 

 

 

Starting Salary and Title:                             Ending Salary and Title:

 

Reason for Leaving:

 

 

May we contact this employer for a reference? Yes   No

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, Employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or  individuals from all liability when responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

 

Signature of Applicant:________________________________________________ Date:___________________________________

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