Online Application CONTROLLED AIR, INC IS AN EQUAL OPPORTUNITY EMPLOYER. THIS MEANS THAT THE COMPANY CONSIDERS ALL APPLICANTS FOR ALL POSITIONS WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, RELIGION, AGE, SEX, MARITAL STATUS, PREGNANCY, SEXUAL ORIENTATION, THE PRESENCE OF NON-JOB RELATED MEDICAL CONDITION OR DISABILITY, VETERAN STATUS OR ANY OTHER LEGALLY PROTECTED CLASS. Date* MM slash DD slash YYYY Personal InformationName* First Middle Last Current Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Other/ Cell PhoneEmail* Are you legally eligible for employment in the United States?*(If Yes, verification will be required.) Yes No Are you under the age of 18?* Yes No Are you requesting any accommodation to complete the application process?* Yes No Employment DesiredJob Position applied for:*HVAC Service TechnicianHVAC ApprenticeAssistant Project ManagerSheet Metal MechanicSheet Metal ApprenticeProject Manager InternProject ManagerHVAC PipefitterHVAC EstimatorOtherPlease write in position applying for: Date Available* MM slash DD slash YYYY Salary Desired: Interest* Regular/Full Time Part-Time Temporary Summer Other Other Were you referred by any of the following?Newspaper AdvertisementEmployment AgencyEmployeeSocial MediaOtherPlease provide details of your referral:Name of newspaper, employee, details of other. Are you currently employed?* Yes No If so, may we inquire of your present employer?* Yes No Have you ever applied to work for Controlled Air before?* Yes No If Yes, When? Were you hired? Yes No Employment InformationAre you physically and mentally able to perform the job applied for?* Yes No If no, is there any accommodation that would allow you to perform this job? Yes No Can you work overtime?* Yes No Can you work overtime without prior notice?* Yes No Can you work on Saturday?* Yes No Can you work on Sunday?* Yes No Can you travel out of state if required by this position?* Yes No Driver InformationMany positions at Controlled Air require employees to drive. If you are applying for a driver’s position or a position which requires driving, please answer the following: Do you have a valid driver’s license?* Yes No License Number* State* Expiration Date* Do you have a CDL?* Yes, Class A Yes, Class B No Has your license ever been revoked or suspended?* Yes No Educational HistoryElementary/Middle SchoolSchool Name Year Completed Diploma/Degree Received? Yes No Subjects Studied High SchoolSchool Name* Year Completed* Diploma/Degree Received?* Yes No Subjects Studied* CollegeSchool Name Year Completed Diploma/Degree Received? Yes No Subjects Studied Trade SchoolSchool Name Year Completed Diploma/Degree Received? Yes No Subjects Studied OtherSchool Name Year Completed Diploma/Degree Received? Yes No Subjects Studied Describe specialized training, apprenticeship, skills or extra-curricular activities that relate to the position for which you are applying (omit any activities that would disclose your race, religion or other protected class):Employment HistoryList below all of your employers for the past five years. Position 1Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 1Position 2Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 2Position 3Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 3Position 4Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 4Position 5Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 5Position 6Start Date End Date Name & Address of EmployerSalary Position Reason For Leaving end position 6Which of these jobs did you like best? What did you like most about this job?If you need more space for your last five year, please write it in below:ReferencesGive names of three persons not related to you, whom you have known for at least one year, who can provide a reference: Reference 1Name 1 First Last Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State PhoneOccupation Years Known reference endReference 2Name 2 First Last Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State PhoneOccupation Years Known reference endReference 3Name 3 First Last Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State PhoneOccupation Years Known reference endState any additional information you feel may be helpful to us in considering your application:TO ALL APPLICANTS: PLEASE READ THIS SECTION CAREFULLY AND SIGNIFY YOUR UNDERSTANDING BY SIGNING YOUR NAME IN THE SPACE PROVIDED. I certify that all of the statements made by me on this application for employment are true, correct, and complete to the best of my knowledge. I understand that any falsification or material omission of fact on this application shall lead to refusal of employment or dismissal from employment. I authorize the Company to check the references provided, and further authorize the investigation of all matters contained in this application to verify its accuracy. I understand that the Company follows an “EMPLOYMENT AT WILL” policy, in that, I or the Company, may terminate my employment at any time, with or without notice, for any reason consistent with applicable State or Federal law. I understand that all employment appointments are “introductory,” during which “introductory period,” I must demonstrate my fitness for continued employment. I further understand that successful completion of the introductory period does not guarantee continued employment. I understand that, as part of the application process, the Company conducts thorough background checks (which may include a check of my criminal history) on prospective employees. I agree that, if contacted with respect to such background check, that I will fully cooperate and provide any information requested. I understand that I am not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased pursuant to Connecticut General Statutes sections 46b-146, 54-76o or 54-142a. The applicant is not required to disclose the existence of criminal records that are subject to erasure pursuant to Connecticut General Statutes sections 46b-146, 54-76o and 54-142a which are records pertaining to a finding of delinquency or that a child was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge that has been dismissed or nolled, a criminal charge for which the person has been found not guilty or a conviction for which the person received an absolute pardon, and The applicant is not required to disclose the existence of criminal records have been erased pursuant to Connecticut General Statutes sections 46b-146, 54-76o or 54-142a since the applicant shall be deemed to have never been arrested within the meaning of the general statutes with respect to these proceedings so erased and may so swear under oath. As a condition of employment, I understand that information relative to the status of any driving duties, particularly insurability of an employee who drives as part of his/her job, is an important job function. In the event that I am called upon to drive as part of my job functions with the Company then as a condition of my employment, I hereby authorize my employer and its insurance agent to ask for and receive information relative to the status of my motor vehicle operator’s license and motor vehicle history in every State in which I have held a motor vehicle operator’s license. This authorization is valid from the date of my signature below throughout the term of my employment in which driving a Company motor vehicle is an essential job function. I understand that if at any time (now or in the future) the Company cannot insure me due to my motor vehicle operator history, my employment may be terminated. SignatureDate MM slash DD slash YYYY
