Employment Application - AllPro Appliance

Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Area of Interest*

Joining our team as an Appliance Repair Technician
Office Staff
Customer Service Department

Are you willing to relocate*

Yes
No

Military Experience

Branch of Service

Specialty

Description of work experience:

Date of enlistment:

Date of discharge:

Position Desired*

Salary Desired*

Are you presently employed?*

Yes
No

If yes, may we inquire with your present employer?*

Yes
No

Have you ever applied at All Pro Appliance Service, Inc. company before?*

Yes
No

If yes, where?

When?

Have you ever worked at All Pro Appliance Service, Inc. company before?*

Yes
No

If yes, when?

What was your reason for leaving?

List the schools you have attended

Name:

Location:

Years you attended this school:

Did you graduate?

Yes
No

Name:

Location:

Years you attended this school:

What did you study?

Did you graduate?

Yes
No

Name:

Location:

Years you attended this school:

What did you study?

Did you graduate?

Yes
No

Driving Record:

Do you have a clean driving record?*

Yes
No

If no, please explain:*

Please list your last three employers, starting with the most recent or current employer.

Present / Last Employer:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Name of Supervisor:

May we contact your supervisor?

Yes
No

Description of Work:

Reason for Leaving:

Present / Last Employer:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Name of Supervisor:

May we contact your supervisor?

Yes
No

Description of Work:

Reason for Leaving:

Present / Last Employer:

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From:

To:

Name of Supervisor:

May we contact your supervisor?

Yes
No

Description of Work:

Reason for Leaving:

Have you ever been convicted of a felony within the last five years?*

Yes
No

If yes, please explain:

Authorization

I understand that the foregoing is a preliminary questionnaire and that, prior to being considered for employment, I will be required to complete an application.I certify that the facts contained in this application are true and complete the best of my knowledge, and I understand that, if employed, falsified statements on this questionnaire shall be grounds for dismissal.I authorize investigation of all statements contained herein and the employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and I release the company from all liability for any damage that may result from utilization of such information.I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

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