PRECISION APPLIANCE EMPLOYMENT APPLICATION

Personal Information

Name *
Prefix
First *
Last *
Suffix
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Phone Number *

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Are you eligible to work in the United States? *
 Yes 
 No 
What date are you available to start? *

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EDUCATION:

Name and Address Of School - Degree/Diploma - Graduation Date *
Skills and Qualifications: Licenses, Skills, Training, Awards *

EMPLOYMENT HISTORY:

Present Or Last Position:
Name of Employer: *
Employers Address: *
Immediate Supervisor: *
Phone Number *

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Position Title: *
Start Date *

MM
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DD
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YYYY
End Date *

MM
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DD
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YYYY
Duties Performed *
Salary *
Input hourly wage, if not salaried.
Reason for Leaving: *

Previous Position
Employer: *
Address: *
Supervisor: *
Phone Number *

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Position Title: *
Start Date *

MM
/
DD
/
YYYY
End Date *

MM
/
DD
/
YYYY
Responsibilities: *
Salary *
Input hourly wage, if not salaried.
Salary expected if hired by Precision Appliance *
Reason for Leaving: *
May We Contact Your Present Employer? *
 Yes 
 No 
References: Please Provide 3 references
Name/Title Address Phone
*

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
Do you agree with the terms and conditions? *
 Yes, I agree. 
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