HVAC/R Employment Application "*" indicates required fields Personal InformationName* First Last Social Security Number* Present 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 Permanent Address* Same as previous 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 PhoneCell Phone*Referred By Email Address* How Did You Hear About Our Company* Employment InformationAre You Authorized to Work in the US?* Yes No Current Employer (if any) When Can You Start* Years of Work Experience Directly Related to the Position You Are Applying For* Employment Type* Full Time Part Time Desired Hourly Compensation*EducationEducation Including High School, College/University, Trade School, Other*Type of SchoolName of SchoolLocationMajor/Degree Add RemoveWork ExperiencePlease list your work experience for the last 5 years, beginning with your most recent job. This also applies if you were self-employed. How Many Employers Would You Like to List?* 1 2 3 4 Name of Employer* Name of Last Supervisor* From Date* To Date* Address with City/State/Zip* Phone* Starting Pay* Ending Pay* Job Title* Specific Reason for Leaving* May We Contact This Employer?* Yes No List the Jobs You Held, Duties Performed, Skills Used or Learned, Advancements or Promotions While You Worked at This Company* Employer 2Name of Employer* Name of Last Supervisor* From Date* To Date* Address with City/State/Zip* Phone* Starting Pay* Ending Pay* Job Title* Specific Reason for Leaving* May We Contact This Employer?* Yes No List the Jobs You Held, Duties Performed, Skills Used or Learned, Advancements or Promotions While You Worked at This Company* Employer 3Name of Employer* Name of Last Supervisor* From Date* To Date* Address with City/State/Zip* Phone* Starting Pay* Ending Pay* Job Title* Specific Reason for Leaving* May We Contact This Employer?* Yes No List the Jobs You Held, Duties Performed, Skills Used or Learned, Advancements or Promotions While You Worked at This Company* Employer 4Name of Employer* Name of Last Supervisor* From Date* To Date* Address with City/State/Zip* Phone* Starting Pay* Ending Pay* Job Title* Specific Reason for Leaving* May We Contact This Employer?* Yes No List the Jobs You Held, Duties Performed, Skills Used or Learned, Advancements or Promotions While You Worked at This Company* HVAC/R Industry SkillsHVAC/R Industry Skills Section Instructions: Only select the specific industry skills that you consider yourself to be very knowledgeable about, with a high level of competency.What Size of Hvac/R Equipment Have You Worked With? (Select All That Apply)* 1-5 Tons 5-20 Tons 20-50 Tons 50-100 Tons 100+ Tons What Manufactures Equipment Have You Worked With? (Select All That Apply)* American Standard Cummins & Woodward Ice O Matic Manitowoc Seibe Trane Andover Controls Daikin ICEE Maytag Siemens Traulsen Beverage Air DelField Johnson Controls McQuay Storlting TRUE Bryant Electro Freeze Kelvinator Perlick Tappan United Carrier Gidaire Kold Draft Philco Taylor Victory Coleman Gibson Lennox Rheem Tekmar Vogt Cornecius Honeywell Liebert Ruud Thermo King Westinghouse Crystal Tip Hoshizaki Luxaire Sani Serv Toshiba York What Types of Equipment or Systems Have You Worked With? (Select All That Apply)* 410A Centrifugal Enviro. Test Chambers Humidification Propane Variable Speed Equip. Absorption System Chilled Water Exhaust Systems HVAC Equipment Puron VAV Air Dist. Equipment Chillers FCB Machines Hydronic Radiant Heating Ventilation Air Handlers Cold-Plate Systems Forced Air Systems Ice Cream Machines Reach-Ins VRF Ammonia Commercial Cooking Eqpt Freezers-Commercial Ice Machines Reciprication VRV Anti-Vibrations Cooling Towers Frozen Bev. Machines In-Floor Refrigeration Walk-ins Appliances Dehumidification Furnace Oil Refrigerators Washers-Clothes Appliances-Home Dish Washers Gas Ovens-Electric Rooftop Units Water Heaters Bobtail Units Dry Systems Gas Stoves Ovens-Gas Split Systems Wet Systems Boilers Dry-Coolers Geo Thermal Package Units Steam Window Units AC Cascade Refrigeration Dryers-Clothes Ground Source Heat Pump Parallel Refrigeration Trailer Units Central Plants Electric Stoves Heat Pumps Portable HVAC Transport Refrigeration What Types of Parts and Accessories Have You Worked With? (Eslect All That Apply)* Coils Dampers Electric Motors HVAC Parts Sound Attenuators Compressors Diffusers Fans Registers Vacuum Pumps Condensers Duct Work Grills Sheet Metal Valves What Applications Do You Have Experience With? (Select All That Apply)* Clean Rooms Controls-Programming Industrial Light Commercial Off-Shore Residentail Cold Storage Government Projects DDC Marine Pools Resaurants Commercial Grocery Stores Institutional Pneumatic Controls Buliding Automation Snow Melting Floating Floors Hospitals International Multi-Family Controls Controls-Design Certifications and LicensesWhat Certifications and Licenses Do You Have:? (Select All That Apply)* (CAMT) Certified Apartment Maint Tech HVAC Excellence-Comm. Refrigeration ICE-Commercial Refrigeration NATE-A/C Certified Energy Manager HVAC Excellence-Electrical Heat ICE-Light Commercial A/C & Heating NATE-Air Distribution EPA 608 Type I HVAC-Excellence-Gas Heat ICE-Residential A/C & Heating NATE-Gas Heat EPA 608 Type II HVAC Excellence-Geothermal Journeyman HVAC License NATE-Heat Pumps EPA 608 Type III HVAC Excellence-Heat Pump Journeyman Plumber License NATE-Oil Heating EPA 608 Type Universal HVAC Excellence-Hydronics I Master HVAC License Oil Burner License HVAC Excellence-A/C HVAC Excellence-Hydronics II Master Plumber License Registered Pro. Engineer HVAC Excellence-Commercial A/C HVAC Excellence-Oil Heat Include State and License # For Any Licenses Selected Above, if ApplicableStateLicense # Add RemoveProfessional ReferencesProfessional ReferencesNamePositionCompanyPhoneEmail Address Add RemoveAGREEMENT AND AUTHORIZATION (PLEASE READ CAREFULLY BEFORE SIGNINGName* First Last Consent* I Agree to Sign ElectronicallyDate* MM slash DD slash YYYY I Certify That All the Information on This Application Is Accurate and Complete to the Best of My Knowledge and Understand That Misleading or False Statements Will Constitute Sufficient Cause for Refusal of Hire or Termination of My Employment. Advanced Mechanical Services Is an Equal Employment Opportunity Employer and We Are a Drug Free Work Place. We Adhere to a Policy of Making Employment Decisions Without Regard to Race, Color, Religion, Sex, Sexual Orientation, National Origin, Citizenship, Age, Disability, Veteran’s Status or Genetic Information.*