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Please fill in all requested information, and mail or fax it to us:
©Mechanical
Insulation Specialist Personnel Dept.
2245 N Green Valley Pkwy #291
Henderson, Nevada 84014
Phone: 702 567-1001
Fax: 702 565-4648
Instructions & Checklist
Employment Application
[_] This package contains: (1) Instructions and Checklist for the Employment Application; (2) Employment Application.
[_] This application makes assertions regarding the company’s practice of providing equal employment opportunities; review your company’s policy to ensure its accuracy.
[_] The applicant should sign the employment application.
[_] If the applicant is hired, a copy of their employment application should be kept with their other employment records.
[_] Laws vary from time to time and from state to state. These forms are not intended to be and are not a substitute for legal advice. Employers should consult with their attorneys before using this application to ensure that it complies with all laws.
[_] The purchase and use of these forms is subject to the “Disclaimers and Terms of Use” found at findlegalforms.com.
It is the policy of this company to provide equal employment opportunities to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, physical or mental handicap or veteran status.
Note: Please type or print your answers. If you print, please do so in blue or black ink and write neatly. An illegible application may preclude you from consideration.
POSITION APPLYING FOR: ______________________________________________________________
PERSONAL INFORMATION
First Name Middle Initial Last Name
Current Address:
Street and Apt. # City State Zip Code
Permanent Address (if different from above):
Street and Apt. # City State Zip Code
Telephone: _________________________ E-mail:________________________
Social Security #: _____-_____-______ Driver’s License #: ________________ State: _____
I am an U.S. Citizen or otherwise authorized to work in the United States on an unrestricted basis:
? Yes ? No
If applicable, please list your visa type, visa # and expiration: ____________________________
Have you ever been convicted of a felony? ? Yes ? No
If you answered yes, please explain:
Have you ever served in the U.S. Military? ? Yes ? No
If yes, please provide the following information:
Branch of Service: ____________________ Rank at time of separation: __________________
I served from _____________________ to ___________________________.
Special Honors:
EMPLOYMENT HISTORY:
Present or Most Recent Employer
Employer: __________________________________ Address: _______________________________________
Your Position: _______________________________ Salary: _________________________________________
Duties:__________________________________________________________________________________________
Dates of Employment:_____________________ to _____________________________
Supervisor:_________________________ _____________________________ May we contact? ? Yes ? No
Name Title
Reasons for Leaving:_________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Prior Employer
Employer: __________________________________ Address: _______________________________________
Your Position: _______________________________ Salary: _________________________________________
Duties:__________________________________________________________________________________________
Dates of Employment:_____________________ to _____________________________
Supervisor:_________________________ _____________________________ May we contact? ? Yes ? No
Name Title
Reasons for Leaving:_________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Prior Employer
Employer: __________________________________ Address: _______________________________________
Your Position: _______________________________ Salary: _________________________________________
Duties:_______________________________________________________________________________
Dates of Employment:__________________ to _________________________
Supervisor:_____________________ _______________________ May we contact? ? Yes ? No
Name Title
Reason for leaving: _____________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
_____________________________________________________________________________
Name and Address
Did you graduate? o Yes o No Attended from _________ to _________.
If you did not graduate, did you receive your GED? o Yes o No
Special honors or awards:______________________________________________________
Technical or Vocational School
_____________________________________________________________________________
Name and Address
Did you graduate? o Yes o No Attended from __________ to _________.
Degree or Certification:_____________________ Specialty: ________________________
Special honors or awards:_______________________________________________________
College or University
____________________________________________________________________________
Name and Address
Did you graduate? o Yes o No Attended from __________ to _________.
Degree:________________________ Major: _______________________________
Special honors or awards:______________________________________________________
College or University
____________________________________________________________________________
Name and Address
Did you graduate? o Yes o No Attended from __________ to _________.
Degree:________________________ Major: _______________________________
Special honors or awards:______________________________________________________
POSITION INFORMATION:
Position Specifications
Position Applying For: ____________________________________________________
How did you hear about this job? __________________________________________
What hours are you willing to work? ________________________________________
Would you be able to work weekends? ? Yes ? No
Are you willing to travel for the job? ? Yes ? No
When would you would you be able to start? _________________________________
Skills
Please describe any skills you have in the following areas:
Computer: _____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Languages Spoken (other than English): _____________________________________________________________________________________
Other:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate any aspect of my prior educational and employment history.
Furthermore I understand that if I am hired, employment with this company is "at will," which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.
Signature: ________________________________ Date ________________