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Position applying for:
Personal Information
Application Date:  select
First name (*): Last name: (*) MI:
Present address:
City: State: ZIP:
Phone: Alt. Phone:
Best time to call:
Email address (*):
Desired Employment Information
Desired compensation:
Date you are available to begin work:  select
Are you seeking full or part time employment? Full time Part time
Are you presently employed? Yes No
If yes, may we inquire of your employer? Yes No
Are you willing to work a variety of shifts? Yes No
Educational History
Are you a high school graduate? Yes No
Have you received a college degree? Yes No
If so, please describe:
Are you a technician in the State of Wisconsin? Yes No
Previous Employment
Please list the last four (4) employers, starting with the most current first.
Name of employer: Length of employment:
Position: Salary:
Reason for leaving:
Name of employer: Length of employment:
Position: Salary:
Reason for leaving:
Name of employer: Length of employment:
Position: Salary:
Reason for leaving:
Name of employer: Length of employment:
Position: Salary:
Reason for leaving:
Employment Interest
Please explain why you would like to work for Pat's Heating & Air Conditioning, Inc.
Please explain why you think you are the best candidate for this position.
Agree and Apply
I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that if employed, falsified information on this application will be grounds for termination. I authorize investigation of all statements herein and the employers listed above to give all information concerning my previous employment and any pertinent information they may have, and release the company from all liability for any damage that may result from utilization of such information.
I agree  

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