926 State Street, Lemoyne, PA 17043  |  Phone 717-761-2559  |  Fax 717-761-4944  | E-mail

HVAC | Serving the heating and cooling needs of Central Pennsylvania | Harrisburg, Hershey, Camp Hill, Mechanicsburg, Carlisle, and Dillsburg

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Application For Employment

*Required Field

Disclaimer

I UNDERSTAND THAT NEITHER THIS APPLICATION NOR ANY COMMUNICATION BY A MANAGEMENT REPRESENTITIVE IS INTENDED TO CREATE OR DOES CREATE A CONTRACT OF EMPLOYMENT, OFFER OR PROMISE OF EMPLOYMENT. I ACKNOWLEDGE THAT IF HIRED BY THE COMPANY EMPLOYMENT IS ON AN AT WILL BASIS. THIS MEANS THE COMPANY IS FREE TO TERMIMATE MY EMPLOYMENT AT ANY TIME WITH OR WITH OUT CAUSE OR ADVANCE NOTICE. IN ACCORDANCE WITH STATE LAW AND ACCEPTANCE OF EMPLOYMENT IS NOT A CONTRACT OF EMPLOYMENT FOR ANY SPECIFIED TIME. SIMILARLY, I AM FREE TO TERMINATE MY EMPLOYMENT WITH THE COMPANY AT ANY TIME FOR ANY REASON THIS AT-WILL PROVISION MAY BE MODIFIED OR WAIVED ONLY IN A WRITTEN AGREEMENT SIGNED BY AN AUTHORIZED REPRESENTATIVE OF THE COMPANY AND ME. I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.

We are an equal opportunity employer. Applicants are considered for positions without regard to race, religion, sex, national origin, age, Disability or any other consideration made unlawful by applicable federal, state, or local laws.

Personal Information

*First Name
*Middle Initial
*Last Name
*Social Security Number - -
Date of Birth
Marital Status
*Address 1
Address 2
*City
*State
*Zip
*Home Phone - -
Work Phone - -
Mobile Phone - -
E-mail Address

Position and Salary

*Position Applied For
*Desired Salary
Are you interested in applying for our paid family health insurance policy?
 

Emergency Contact Information

*Full Name
*Phone 1 - -
Phone 2 - -
*Relationship

Eligibility and Availability

*Are you able at the time of employment to submit verification of your legal right to work in the U.S.?
(Verification and completion of form I-9 must be submitted no later than three business days after date of hire.)
 
If under the age of 18, can you produce the necessary work certificate at the time of employment?
 

*Type of employment desired
 
Hours desired

*Are you willing to work overtime?
 
*Date on which you can start

Security

*Within the past ten years, have you been convicted of a felony?
(Do not include convictions that were sealed, eradicated, erased, or expunged; convictions that resulted in referral to a diversion program; or marijuana-related convictions that are more than two (2) years old).
 

If yes, please explain so that individual circumstances can be considered.
 
*Have you ever initiated an act of violence in the workplace?
 
If yes please explain so that individual circumstances can be considered.
(A yes answer will not automatically disqualify you from employment)
 

Note: Criminal convictions will not automatically disqualify an applicant from a particular job. The Company will consider the nature of the crime, its seriousness, whether the conviction(s) substantially relates to the positions's functions and qualifications, the frequency of convictions, the applicants age at the time of conviction, the time elapsed since the date of conviction or completion of jail sentence, the applicant's entire work and educational history, and employment references and recommendations.

An ex-offender who is denied employment may, upon written request, receive a statement of the reason(s) for denial within 30 days of the applicant's request for such information.

Education, Skills and Experience

  Name/Location Major Did you graduate? # of Yrs Completed Degree Earned
High School
Tech School
College
 
Please describe any other applicable training:
 
List any skills you feel qualify you for this position:
 

Employment History

Employer 1 (most recent)
*Company Name
*Address 1
Address 2
*City
*State
*Zip
*Phone - -
*Dates Employed
From
To
*Job Title
*Supervisor's Name
*Duties
*Salary
Start
Finish
*Reason For Leaving
*May we contact this employer?




Employer 2  
Company Name
Address 1
Address 2
City
State
Zip
Phone - -
Dates Employed
From
To
Job Title
Supervisor's Name
Duties
Salary
Start
Finish
Reason For Leaving
May we contact this employer?



Employer 3  
Company Name
Address 1
Address 2
City
State
Zip
Phone - -
Dates Employed
From
To
Job Title
Supervisor's Name
Duties
Salary
Start
Finish
Reason For Leaving
May we contact this employer?



Personal References

Reference 1  
*First Name
*Last Name
*Address 1
Address 2
*City
*State
*Zip
*Phone - -
*Best Time to Call
*Relationship
*Number of Years Known

Reference 2  
*First Name
*Last Name
*Address 1
Address 2
*City
*State
*Zip
*Phone - -
*Best Time to Call
*Relationship
*Number of Years Known

Reference 3  
First Name
Last Name
Address 1
Address 2
City
State
Zip
Phone - -
Best Time to Call
Relationship
Number of Years Known

Certification and Release

I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid drivers license and automobile liability insurance in an amount equal to the minimum required by the state where I reside.

I understand that the company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the company has such a program an I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug free workplace, consistent with applicable federal, state and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state and local law may be subject to urinalysis and/or blood screening or other medically recognized test deigned to detect the presence of alcohol or controlled drugs. If employed, I understand that the taking of alcohol and/or drug test is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state and local law.

If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state and local law, may exercise its right, without prior warning or notice to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.

I understand and agree that as a condition of employment and to the extent permitted by federal, state and local law, I may be required to sign a confidentiality, non-compete, and/or conflict of interest statement.

I certify that all of the information on this application is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action up to and including immediate dismissal.

I authorize the Company or it's agents to confirm all statement contained in the application and/or resume as it relates to the position I am seeking and to the extent permitted by federal, state or local law. I agree to complete any requisite authorization forms for the background investigation.

I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the company or its duly authorized representative pursuant to this authorization from any liability clams, charges, or liability the Company and it representatives for seeking such information and all other persons. , corporations, or organizations furnishing such information.

I understand this Company hires only individuals who are legally eligible to work in the United States.

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