Advanced Services Heating & Cooling Inc. HVAC/R EMPLOYMENT APPLICATION 221 Renick Ave. Chillicothe, OH 45601 (740) 773-4499 Fax: (740) 773-6245 (s) Applying for:il (Please Print Clearly - complete all 6 pages) www.advancedserviceshvac.com Application Date:,, Personal Information First : Last : --'- Address: City: State: Zip: Home Work - ext Cell - : (if available) Howdidyouhearaboutourco~pany?----------------------------------------- Emplo ment Information CitizenshiplWork Status: 0 u.s. Citizen 0 Green Card Holder 0 U.S. Work PermiWisa 0 Canadian Citizen 0 Canadian Work PermiWisa Current Employer: (if any) Years of Work Experience directly related to the position you are applying for: Employment Type Desired: ofull-time OPart-Time Desired Compensation: $ OHourly OAnnual When are you available to start work? I Education TYPE OF SCHOOL NAME OF SCHOOL LOCATION High School # OF YEARS COMPLETED MAJOR & DEGREE College/University ~~ Bus. or Trade School Professional School Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC e 2010 MyOpenJobs, LLC 1 of 6
,. Criminal Histo HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR (except any minor traffic violations)? 0 No 0 Yes If yes, please explain and attach any relevant documentation.. '.'. Drivers License Information DO YOU HAVE A VALID DRIVER'S LICENSE? 0 Yes 0 No Do you have reliable transportation to work (please be specific)? Driver's license number: State of Issue: o Operator 0 Commercial (CDL) OChauffeur Do you have a clean driving record? 0 Yes o No List any Moving Violations and/or Accidents from the last 3 years: Milita Service HAVE YOU EVER BEEN IN THE ARMED FORCES? DYes 0 No Branch: ARE YOU CURRENTLY A MEMBER OF THE NATIONAL GUARD or. RESERVES? DYes 0 No Specialty Date Entered Discharge Date.:..','.. Work Experience Please list your work experience for the past 5 years beginning with your most recent job. If you were self-ernploved, qive firm name. Attach additional sheets if necessary. Attach Resume if applicable of employer: of last supervisor Employment Payor salary Address with city/state/zip: Specific reason for leaving List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. of employer: of last supervisor Employment Payor salary Address with city/state/zip: Specific reason for leaving List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. Employment Application supplied for free by hvacagenlcom. HVAC Agent is a division of MyOpenJobs, LLC 2010 MyOpenJobs, LLC 2 of 6
of employer: of last supervisor Employment Payor salary Address with city/state/zip: Specific reason for leaving List the jobs you held, duties performed, skills used or learned, advancements or,promotions while you worked at this company. of employer: of last supervisor Employment Payor salary Address with city/state/zip: Specific reason for leaving List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. HVAC/R INDUSTRY SKILLS SECTION INSTRUCTIONS: knowledgeable about, with a high level of competency. ONLY select the specific industry skills that you consider yourself to be Y Ei. HVAC/R Industry Skills What Size of HVAC/R equipment have you worked with? (Select all that apply) o 1-5 ns 0 5-20 ns 0 20-50 ns What Manufacturers Equipment have you worked with? (Select all that apply) o American Standard 0 DelField 0 Kold Draft o Andover Controls 0 Electro Freeze 0 lennox o Beverage Air 0 Frigidaire 0 Liebert OBryant 0 Gibson 0 luxaire o Carrier 0 Honeywell 0 Manitowoc o Coleman 0 Hoshizaki 0 May tag o Cornecius 0 Ice 0 Matic 0 McQuay o Crystal Tip 0 ICEE 0 Perlick o Cummins & Woodward 0 Johnson Controls 0 Philco o Daikin 0 Kelvinator 0 Rheem What types of Equipment or Systems have you worked with? (Select all that apply) o 410A 0 Chillers 0 Freezers - Commercial o Absorption Systems 0 Cold-Plate Systems 0 Frozen Beverage Machines o Air Dist. Equipment 0 Commercial Cooking Equip 0 Furnace o Air Handlers 0 Cooling wers 0 Gas o Ammonia 0 Dehumidification 0 Gas Stoves o Anti-Vibrations 0 Dish Washers 0 Geo Thermal o Appliances 0 Dry Systems 0 Ground Source Heat Pumps o Appliances - Home 0 Dry-Coolers 0 Heat Pumps o Bobtail Units 0 Dryers - Clothes 0 Humidification o Boilers 0 Electric Stoves 0 HVAC Equipment o Cascade Refrigeration 0 Environmental Test Chambers 0 Hydronic o Central Plants 0 Exhaust Systems 0 Ice Cream Machines o Centrifugal 0 FCB Machines 0 Ice Machines o Chuted Water 0 Forced Air Systems 0 In-Floor o 50-100 ns Ruud Sani Serv Seibe o Siemens o Storlting 0 Tappan Taylor o Tekmar o Thermo King o Oil o Ovens - Electric Ovens - Gas Package Units Parallel Refrigeration o Portable HVAC o Propane o Puron o Radiant Heating o Reach-Ins o Recipricating o Refrigeration o Refrigerators o Rooftop Units o 100+ ns o shiba o Trane o Traulsen o TRUE o United ; o Victory o Vogt o Westinghouse o York o Split Systems o Steam o Trailer Units Transport Refrigeration o Variable Speed Equipment OVAV o Ventilation o VRF OVRV Walk-Ins o Washers - Clothes o Water Heaters o Wet Systems o Window Units AC Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs. llc 2010 MyOpenJobs. LLC 3 of 6
What types of Parts and Accessories o Coils o Dampers o Compressors o Diffusers o Condensers HVAC/R Indust Skills Continued have you worked with? (Select all that apply) Electric Motors a Fans a Duct Work a Grills a HVAC Parts a Registers a Sheet Metal a Sound Attenuators a Vacuum Pumps a Valves ----------.- ------------.--------.... -....-----.....--........ --..--. What Applications do you have experience with? (Select all that apply) o Clean Rooms a Government Projects o Institutional o Cold Storage Grocery Stores o International o Commercial o Hospitals Light Commercial CJ Floating Floor a Industrial o Marine o Multi Family o Off-Snore o Pools a Residential o Restaurants a Snow Melting What types of Building Automation or controls experience do you have? :J Building Automation 0 Controls Design 0 Controls Programming 0 DOC o Pneumatic controls gc2.."-~c:>i~...................... What Job Functions have you performed? (Select all that apply) o Activity Reporting a EngineerlPE o Advertising (broadcast) 0 Estimating o Advertising (online) 0 Estimator o Advertising (print) 0 Executive Assembling 0 Expense Reports o Brazing 0 Fabrication o Budgeting 0 Facility Manager Business Development 0 Field Supervisor o Call Center Management 0 Forecasting o Carpentry 0 Foreman o Change Orders 0 General Construction o Channel Development 0 General Manager o Client Interaction 0 Goal Setting ClienUAccount Management 0 Heat Transfer o Cold Calling 0 Inspector o Commission Development 0 Installation o Computer Literate 0 Installation New Homes o Consultative Selling 0 Installer o Contract Negotiations 0 Instructor o ContracUProposal Preparation 0 International o Conventions/Trade Shows 0 Journeyman o Customer Service 0 Lead Generation o Data Entry 0 Lead Management o Department Forecasting 0 Leadership o Design/Build 0 LEED o Designer 0 Load Calculations o Develop Relationships/Alliances 0 Machine Operator o Dispatcher 0 Maintenance o Drafting 0 Maintenance - Apartment o Draftsman 0 Manager o Driving 0 Manufacturer Rep o Drywall Repair 0 Manufacturing o Electrical 0 Market Analysis o Energy 0 Material Handler o Energy Management 0 NATE Certification o Engineer/BSME 0 NEBB What Computer related experience do you have? (Select all that apply) o ACT 0 Echelon 0 Lon Works o Approach 0 Energy Pro 0 l.on-based Cicron o AutoCad 0 Estimation (software) 0 Manual J o Derby 0 Goldmine 0 Microstation o Ecco Pro 0 LoadfTrace 700 0 MS Access What Certifications & Licenses do you have? (Select all that apply) Negotiate Contracts o Operations Manager o P&L o Pipefitter o Piping o Ptan-OiGrams/Schernat.cs o Plan/Spec o Planning o PLC Plumbing o Policy/Procedure Development o Prepare Financial Reports Presentation Preparation o Preventative Maintenance o Product Demonstration o Product Design o Product Development o Product Testing Production o Production Specialist o Project Management o Project Scheduling o Proposal Development o Proposal Presentation o Prospecting/Lead Generation o Punch List o Purchase Orders o Purchasing o QNQC Manager Quality Assurance/Control Reading Blueprints o Relationship Management o Repair o Report Generation o Reporting o Research Certifications & Licenses OMS Excel OMS Office o MS PowerPoint OMS Word o QuickPen a Retro Fit a Sales o Sales - In Home o Sales - Residential o Sales - Retail Sales Wholesale o Sales Management, Area Sales Management, National o Sales Management, Regional o Sales Manager o Sales Training Development o Service o Service Agreements o Service Manager o Sheet Metal Worker a Shipping Coordination o Shipping/Receiving o -up o Steamfitter o Strategic Alliances o Superintendent o Supervision o Take-offs o Team Building Technician Telemarketing Inbound Telemarketing Outbound o Territory Management o Test & Balance o Thermodynamics o Trainer o Troubleshooting o Vendor Coordination o Welder o Welding o SalesLogix o Seibe a Trane DucUPipe Designer a WinSales a Wrightsoft CJ (CAMT) Certified Apartment o Certified Energy Manager o EPA 608 Type I o EPA 608 Type II o EPA 608 Type III Maint Technician EPA 608 Universal o HVAC Excellence NC o HVAC Excellence - Commercial NC HVAC Excellence - Commercial Refrigeration o HVAC Excellence Electrical Heat HVAC Excellence Gas Heat o HVAC Excellence Geothermal a HVAC Excellence - Heat Pumps o HVAC Excellence - Hydronics I o HVAC Excellence - Hydronics II o HVAC Excellence - Oil Heat ICE Commercial Refrigeration o ICE Light Commercial NC & Heating ICE - Residential NC & Heating o Journeyman HVAC License o Journeyman Plumber License o Master HVAC License a Master Plumber License ONATE-NC o NATE - Air Distribution ONATE - Gas Heat ONATE - Heat Pumps a NATE Oil Heating a Oil Burner License a Registered Professional Engineer Include State and License Numbers for any licenses selected above, if applicable: Other Licenses & Certifications held: Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC 2010 MyOpenJobs, LLC 4 of 6
Additional Information Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying. If you have a resume, please include it with this application. Professional References Please list 3-4 people you have worked with who can attest to your On-the-Job experience and performance. Telephone Telephone.>...-~'-- ~ Telephone Telephone Did you complete this application yourself? DYes 0 No Ifnot,whodid? Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC 2010 MyOpenJobs, LLC 5 of 6
AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING) 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. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Advanced Services Heating & Cooling Inc. creates an actual or implied contract of employment. I understand that, if I accept employment with Advanced Services.Heating & Cooling Inc., it will be on an at-will basis. This means that either Advanced Services Heating & Cooling Inc. or I have the right to terminate the employment relationship at any time, for any reason, with or without cause. I agree to submit to drug and alcohol testing, if requested by Advanced Services Heating & Cooling Inc.. I release Advanced Services Heating & Cooling Inc., and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing. I authorize Advanced Services Heating & Cooling Inc. to investigate information concerning my education, licensing,certifications, driving record, criminal history, employment experiences and all other aspects of my background relevant to my proposed employment. I release Advanced Services Heating & Cooling Inc. and its employees from all liability arising from such investigation. Signature of Applicant: Date:,, Print : Advanced Services Heating & Cooling Inc. is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Advanced Services Heating & Cooling Inc. depends solely on your qualifications. Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs. LLC 2010 MyOpenJobs. LLC s er:s