Date of Application
January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009 2010

Name (Last, First, MI)
,

Street Address

City, State, Zip)
,

Cell Phone

Alternate Phone

Email

Are you a U.S. citizen or authorized to work in the U.S.?
Yes No

Did you complete high school or have a GED?
Yes No

Indicate specific college degree and issuing institution (if any).

Indicate specific technical, apprenticeship or military training (if any).

Indicate any foreign languages in which you are fluent (if any).

Do you have an OSHA 10 or 30 Training Certificate?
Yes No

Are you willing to attend orientation classes?
Yes No

Are you willing to attend training or upgrade classes?
Yes No

Do you have dependable means of transportation?
Yes No

List general locations within Georgia in which you would prefer to work.

Do you have a valid Drivers License? If so, list the issuing state.
Yes No

Are you able to climb and work from ladders, scaffolds & lifts?
Yes No

How much weight can you comfortably lift and carry?
20 lbs. 40 lbs. 60 lbs. 80 lbs. 100 lbs. 110+ lbs.

Can you understand verbal instructions in English?
Yes No

Your current employer (if any)?

If employed by a contractor, list the project(s) currently working.

Your position with current employer (if any)?

Current rate of pay (per hour, if any)?

Desired rate of pay per hour?

Previous employer / Pay Rate / Position / Employment Start & Stop Dates?

Previous employer / Pay Rate / Position / Employment Start & Stop Dates?

Previous employer / Pay Rate / Position / Employment Start & Stop Dates?

Years of residential HVAC service experience (if any)?
0 <1 1 2 3 4 5 >5

Years of commercial HVAC service experience (if any)?
0 <1 1 2 3 4 5 >5

Years of residential HVAC installation experience (if any)?
0 <1 1 2 3 4 5 >5

Years of commercial HVAC installation experience (if any)?
0 <1 1 2 3 4 5 >5

Years of industrial HVAC installation experience (if any)?
0 <1 1 2 3 4 5 >5

Years of sheet metal shop experience (if any)?
0 <1 1 2 3 4 5 >5

List types of sheet metal shop machinery you have operated (if any).

Years of patterning & layout experience (if any)?
0 <1 1 2 3 4 5 >5

Years of stick welding experience (if any)?
0 <1 1 2 3 4 5 >5

Years of MIG welding experience (if any)?
0 <1 1 2 3 4 5 >5

Years of TIG welding experience (if any)?
0 <1 1 2 3 4 5 >5

List welding material type and thickness experience (if any).

List welding certification types (if any).

Years of sheet metal siding & decking experience (if any)?
0 <1 1 2 3 4 5 >5

Years of sheet metal roofing experience (if any)?
0 <1 1 2 3 4 5 >5

Years of ship building experience (if any)?
0 <1 1 2 3 4 5 >5

Years of power house construction experience (if any)?
0 <1 1 2 3 4 5 >5

Years of paper mill construction experience (if any)?
0 <1 1 2 3 4 5 >5

Years of combined Sheet Metal / HVAC construction experience (if any)?
0 <1 1 2 3 4 5 >5

Years of related Sheet Metal construction experience (if any)?
0 <1 1 2 3 4 5 >5

Explain related Sheet Metal construction experience (if any).

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