Princeton Air Conditioning Inc.


Name
Company Name
Social Security Number
Current Address
Email
Home Telephone
Cell Phone
WHAT POSITION (POSITIONS) ARE YOU INTERESTED IN?
Service Tech Service Apprentice Installation Tech Installation Apprentice Sales Rep Office Staff Management

REFERRAL SOURCE
LINC Staffing Specialist	Name
Relative	Name
Advertisement	Name
Friend	Name
Website	Name
Other	Name

EDUCATION
High School
School & Location
Course
Grade Average
Grade Completed
Degree
Date Graduated
College
School & Location
Course
Grade Average
Grade Completed
Degree
Date Graduated
Other
School & Location
Course
Grade Average
Grade Completed
Degree
Date Graduated

List extra curricular activities, clubs, and/or other honors:


List other industry study, postgraduate education, seminars, military training, etc. which would be applicable to position(s) applied for:
Dates
Dates
Dates
Dates
Dates

MILITARY
Branch
Dates Served	From To
Highest Rank
Job

EMPLOYMENT HISTORY
Employer's Name
Address
Telephone
Employment Dates	From To
Final Earnings	$ Per
Reason(s) for Leaving
YOUR JOB: Describe below your exact function in the organization. Also specify significant accomplishments and list noteworthy achievements while in this position.

Fill in your manager's name and title. NOTE: THEY WILL NOT BE CONTACTED WITHOUT YOUR PERMISSION.
Manager's Name
Manager's title

Employer's Name
Address
Telephone
Employment Dates	From To
Final Earnings	$ Per
Reason(s) for Leaving
YOUR JOB: Describe below your exact function in the organization. Also specify significant accomplishments and list noteworthy achievements while in this position.

Fill in your manager's name and title. NOTE: THEY WILL NOT BE CONTACTED WITHOUT YOUR PERMISSION.
Manager's Name
Manager's title

Employer's Name
Address
Telephone
Employment Dates	From To
Final Earnings	$ Per
Reason(s) for Leaving
YOUR JOB: Describe below your exact function in the organization. Also specify significant accomplishments and list noteworthy achievements while in this position.

Fill in your manager's name and title. NOTE: THEY WILL NOT BE CONTACTED WITHOUT YOUR PERMISSION.
Manager's Name
Manager's title

OTHER EXPERIENCE, SKILLS, QUALIFICATIONS
List below any other experience, skills, or qualifications, etc. which you feel qualify you for the position(s) you seek:

Professional Licenses and Certificates

REFERENCES
Three persons who know you on a business basis.
Name
Association
Address
Telephone

Name
Association
Address
Telephone

Name
Association
Address
Telephone

MISCELLANEAOUS
List your recreational activities/interests:
What is your ultimate career goal?

IF APPLYING FOR A SERVICE/CONSTRUCTION POSITION
Are you able to perform, with or without reasonable accommodation, manual service/construction activities including:
• lifting and carrying objects weighing up to forty (40) pounds?		Yes No
• reaching for, pushing and pulling construction materials and equipment?		Yes No
• climbing ladders and stairs?		Yes No
• traversing rough and un even surfaces?		Yes No
• standing, balancing, walking, kneeling, crawling, stooping, twisting and squatting to access con- struction and equipment areas and to complete construction/ service tasks?		Yes No
• responding to verbal warnings and instructions		Yes No
• communicating verbal warnings and instructions		Yes No
• Do you have the means to travel to various construction/service sites?		Yes No

IF APPLYING FOR AN ADMINISTRATIVE/SUPPORT POSITION
Are you able to perform, with or without reasonable accommodation, office activities including:
• lifting and carrying objects weighing up to ten (10) pounds?		Yes No
• sitting for extended periods of time up to eight (8) hours?		Yes No
• operating office equipment such as telephones, copy machines, typewriters and computer keyboards?		Yes No
• accessing filing cabinets?		Yes No
Are you willing to travel?		Yes No
What Percent of the Time? %
Are you willing to relocate?		Yes No
Any geographic limitations?		Yes No
Any Preferences?
How did you hear about us? Customer Referral Newspaper Ad Yellow Page Ad I am an existing customer Lawn Sign Mailing Website Television