Application for Employment

The hire must have 2 years of service experience, EPA certification & NATE certification would be paramount. We’re a Family-Owned business offering great benefits/401K & would like to talk to you if you meet our requirements.

Harbin Heating & Air Conditioning, Inc. and its clients provide equal employment opportunities to qualified individuals without regard to race, color, religion, sex (including pregnancy, childbirth, and related medical conditions), national origin, age (40 and over)citizenship, physical or mental disability, or status as a disabled veteran of the Vietnam War.

Job You're Applying For

Receptionist/Call Center Associate

Lead Installer Technician

Date of Birth

YYYY

Application Date

YYYY

Name

First Name

Last Name

Social Security Number

Present Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Do you have a valid driver's license

State

Expiration Date

YYYY

List any friends or relatives working for us.

Do you have any work experience, skills or qualifications that you feel especially qualify for job you are applying for?

Do you want to work:

If hired, available starting date?

YYYY

Have you ever been convicted (including a guilty plea) of a crime, excluding misdemeanors? (A yes answer will not automatically disqualify you for being considered for employment with Harbin Heating & Air Conditioning, Inc.)

If Yes, give the date, place, and describe the offense?

Are you legally authorized to work in the United States?

Are you over the age of 18?

Please tell why you feel you should be hired?

Educational Background

High School Name & Address

Years Attended

Graduated

Course/Major

College Name & Address

Years Attended

Graduated

Course/Major

Post Graduate School & Address

Years Attended

Graduated

Course/Major

Business/Trade School & Address

Years Attended

Graduated

Course/Majoe

Other School & Address

Years Attended

Graduated

Course/Major

Prior Work History (List in order, most recent employer first)

Name & Address of Employer

Supervisor's Name & Title

Supervisor's Phone Number

(###)

###

####

Dates of Employment (From/To)

Rate of Pay (Start/Finish)

Reason for Leaving

Describe Job Duties

Name & Address of Employer

Supervisor's Name & Title

Employer's Phone Number

(###)

###

####

Dates of Employment (From/To)

Rate of Pay (Start/Finish)

Reason for Leaving

Describe Job Duties

*Attach additional work information sheets if necessary

May we contact the employers listed above?

If not, indicate below which one(s) you do not wish to contact and briefly state reason

I affirm that the information I gave in the Employment Application is true and complete. I understand that Harbin Heating & Air Conditioning, Inc. may refuse to hire me or, if I am hired by Harbin Heating & Air Conditioning, Inc., may discharge me if I gave false or misleading information in this application. I understand that persons hired for certain job classifications are required to undergo a physical examination and drug test before beginning work and a post-accident drug test will be required after all work related injuries. No compensation shall be allowed if the employee refuses to submit to or cooperate with a blood or urine test. Any offer of employment or continuation of employment after injury is conditioned upon satisfactory completion of the physical examination and drug test.

Are you willing to undergo a physical examination and drug test if you are offered employment with Harbin Heating & Air Conditioning, Inc.?

Misrepresentations at to preexisting physical or mental conditions may void your workers compensation benefits

Unless I checked “No” to indicate that I do not want Harbin Heating & Air Conditioning, Inc. to contact a former employer to obtain an employment reference and gave the reason for that choice, I authorize each person, school, or former employer identified in the Application of Employment to provide Harbin Heating & Air Conditioning, Inc. with any information that Harbin Heating & Air Conditioning, Inc. may request and I release each such person, school, or employer from any liability or damage related in any way to the furnishing of such information to Harbin Heating & Air Conditioning, Inc.. I understand that, if I am hired by Harbin Heating & Air Conditioning, Inc., Harbin Heating & Air Conditioning, Inc. may terminate my employment at any time and for any reason Harbin Heating & Air Conditioning, Inc. deems sufficient. I understand that no manager, supervisor, employee or other Harbin Heating & Air Conditioning, Inc. representative has any authority to promise employment for a particular length of time, or to make any other promises or other representations about my continued employment with Harbin Heating & Air Conditioning, Inc.

Applicant's Signature

Date

YYYY

Application for Employment

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