EMPLOYMENT APPLICATION
|
|
|
Capital Heat, Inc. is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, creed, sex, age, marital status, national origin, disability, military service, genetic predispostion, or carrier status, arrest record, or any other protected status under applicable Federal, State, and Local laws.
|
|
|
|
PERSONAL INFORMATION
|
| First Name: |
|
| Last Name: |
|
| Street Address: |
|
| City: |
|
| State: |
|
| Zip Code: |
(5 digits) |
| Email Address: |
|
| Confirm Email Address: |
|
| Home Phone Number: |
|
| Cell Phone Number: |
|
| Social Security No: |
|
| Have you ever applied for a position with Capital Heat, Inc. in |
|
| If Yes, please specify the job position(s) applied for and the date(s) of application: |
|
| Have you ever been employed by Capital Heat, Inc. in the past? |
|
| If yes, please specify the job position(s) held and the date(s) of employment:: |
|
| Are you 18 years of age or older? |
(If you are under the age of 18, any employment is subject to verification that you are of minimum legal age and you may need to supply Capital Heat, Inc. with a work permit and/or limit your hours to those permitted by law.) |
| If hired, are you able to provide proof of authorization to work in the United States? |
|
| Other than minor traffic violations, have you ever been convicted of a crime?: |
|
| If yes, please explain in detail: |
|
| Are you able to perform all of the essential functions of the job for which you are applying, with or without reasonable accommodation?: |
|
|
REFERENCES
|
| References |
|
|
EDUCATION
|
| Education |
|
| Please list any academic honors, scholarships, fellowships or memberships in academic honor societies (please exclude those indicating race, color, religion, national origin, gender, etc.): |
|
| Are you licensed member of any trade or profession? |
|
| If yes, please detail: |
|
|
MILITARY SERVICE
|
| Have you served in the United States Armed Forces?: |
|
| If yes, which Branch?: |
|
| Rank at discharge?: |
|
| List special skills/abilities acquired: |
|
|
EMPLOYMENT HISTORY
|
| Employer 1: |
|
| Type of Business 1: |
|
| Address 1: |
|
| Telephone Number 1: |
|
| Dates of Employment 1: |
|
| Job Title(s) 1: |
|
| Last Salary 1: |
|
| Supervisor's Name and Title 1: |
|
| Reason for Leaving 1: |
|
| Employer 2: |
|
| Type of Business 2: |
|
| Address 2: |
|
| Telephone Number 2: |
|
| Dates of Employment 2: |
|
| Job Title(s) 2: |
|
| Last Salary 2: |
|
| Supervisor's Name and Title 2: |
|
| Reason for Leaving 2: |
|
| Employer 3: |
|
| Type of Business 3: |
|
| Address 3: |
|
| Telephone Number 3: |
|
| Dates of Employment 3: |
|
| Job Title(s) 3: |
|
| Last Salary 3: |
|
| Supervisor's Name and Title 3: |
|
| Reason for Leaving 3: |
|
| Employer 4: |
|
| Type of Business 4: |
|
| Address 4: |
|
| Telephone Number 4: |
|
| Date(s) of Employment 4: |
|
| Job Title(s) 4: |
|
| Last Salary 4: |
|
| Supervisor's Name and Title 4: |
|
| Reason for Leaving 4: |
|
| Please list any additional experience of skills that you feel qualify you for the position for which you are applying: |
|
|
IMPORTANT: You must read the following statements. If you have any questions concerning these statements, please ask them before you sign the employment application.
By signing my name below, I certify that all statements made on this application are true, complete and correct to the best of my knowledge and that I understand that any false statements, misrepresentations or omissions may, at the descretion of Capital Heat, Inc. result in rejection of this employment application or immediate dismissal from employment.
By signing my name below, I expressly authorize Capital Heat Inc. to contact any of my prior employers or references listed above. I also expressly release all of those prior employers and references and Capital Heat, Inc. from any and all liability arising from their giving or receiving information about me.
In the event of my employment with Capital Heat, Inc., I will comply with all rules and regulations, and policies of Capital Heat, Inc. I understand that nothing in this employment application, in Capital Heat, Inc.'s policy statements, employee handbooks or personel guidelines, or in my communications with any Capital Heat, Inc. officer or employee is intended to create an employment contract between Capital Heat, Inc. and me. I also understand that Capital Heat, Inc. has the right to modify its policies without giving me any notice of the changes. I acknowledge that no promises regarding employment has been made to me, and I also understand that no such promise or guarantee is binding upon Capital Heat, Inc. unless it is made in writing and signed by an officer of Capital Heat, Inc. I understand that if an employment relationship is established, I have the right to terminate that employment at any time for any reason or no reason and also that Capital Heat, Inc. has the right to terminate that employment at any time for any reason of no reason, with or without notice, with or without cause.
I understand that this application becomes void and will not be considered alfter sixy (60) days, unless renewed in writing by me. I hereby acknowledge that I have read and do understand the preceding statements.
|
|
