Employment Opportunities Thank you for your interest in working with the Certified team! We are always on the look out for exceptional additions to our company. If you are smart, qualified, and great at working with other employees and customers, please complete the following application below. Position ---Accounts PayableOffice AssistantCommercial A/C ServiceResidential A/C ServiceProject ManagerOther Today's Date: Your Name: Social Security #: Home Phone #: Work Phone #: Email: Current Address: City: State: Zip: Prior Address: City: State: Zip: Start Date: Job Category: Full-TimePart-TimeTemporaryLabor Pool Availablity WeekdaysWeekendsEveningsNightsOvertimeShiftOther Valid Driver's License Yes Name on License License #: License Type: State: Moving Violation in the last 7 years? Yes Violations Have you been given a job description? Yes Do you understand essential functions? Yes Can you perform these functions? Yes Have you used any other names or Social Security #'s? Yes Have you been convicted of a crime in the last 7 years? Yes Incident #1: City/State: Charge: Incident #2: City/State: Charge: States & Countries you have lived in: Comments: PREVIOUS EMPLOYMENT Most Recent Employer: City/State: Phone: Fax: Employment Dates Your Title Supervisor Name: Reason For Leaving Salary Job Duties: Previous Employer #1: City/State: Phone: Fax: Employment Dates Your Title Supervisor Name: Reason For Leaving Salary Job Duties: Previous Employer #2: City/State: Phone: Fax: Employment Dates Your Title Supervisor Name: Reason For Leaving Salary Job Duties: REFERENCES Include only individuals familiar with your work ability. Do not include relatives or names of supervisors listed above. Reference #1 Name Address Years Known EDUCATION Highest Grade Completed High School Name City/State Graduated? Obtained Degree? College Name City/State Graduated? Obtained Degree? Other School Name City/State Graduated? Obtained Degree? How did you hear about us? ---RadioAdNewspaper/PrintMonsterIndeedCraigslistPersonal ReferenceCareer CenterOther Disclosure to Employment Applicant Drug-free Workplace Certified AC Services is dedicated to the health and safety of its employees and anyone person who comes in contact with our workplace or uses our services. Given the adverse effects of substance abuse, Certified AC Services is committed to a Drug-Free Workplace. Any violation of this policy will result in adverse action including but not limited to dismissal and prosecution. Regarding Procurement of A Consumer Report The information provided in this Application for Employment is true, correct and complete. If employed, and misstatement or omission of fact on this application may result in dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If hired, I acknowledge that my employment with Certified AC Services will be at-will. In other words, my employment may be terminated at any time, by either party, with or without cause and without notice. I understand and agree that if I will work over forty (40) hours in a workweek, I will be paid overtime compensation if required by federal law. Further, I agree that I will not be paid any extra pay if I work over eight (8) hours in a day. By your signature below, you hereby authorize us to obtain a consumer report about you in order to consider you for employment. Do you agree with the above statement? * I Accept Applicants Name Address City/State/Zip Social Security # Please type your name on the following line as your DIGITAL SIGNATURE: Date Trusted Partners