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A T CONTRACTORS, LLC |
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HVAC/R EMPLOYMENT APPLICATION |
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120 Brookfield Lane |
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(Please Print Clearly – complete all 6 pages) |
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Kingsport, TN 37663 |
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Phone: (423) 239-3358 |
Position(s) Applying for: |
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Fax: (423) 239-7036 |
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www.atcservice.com |
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Application Date: ______/_______/__________ |
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Personal Information |
First Name: _________________________________________________ Last Name: ___________________________________________________
Address: _________________________________________________________________________________________________________________
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City: ____________________________________________________ |
State: _____________________ |
Zip: _________________ |
Home Phone: _____-______-________ |
Work Phone: _____-______-________ ext._____ |
Cell Phone: _____-______-________ |
Email Address: (if available) _________________________________________________________________________________________________
How did you hear about our company? _______________________________________________________________________________________
Employment Information
Citizenship/Work Status: U.S. Citizen Green Card Holder U.S. Work Permit/Visa Canadian Citizen Canadian Work Permit/Visa
Current Employer: (if any) ___________________________________________________________________________________________________
Years of Work Experience directly related to the position you are applying for: ___________
Employment Type Desired: |
Full-Time |
Part-Time |
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Desired Compensation: $_________________ |
Hourly |
Annual |
Other Compensation Desired: _______________________________________________________________________________________________
When are you available to start work? ____________________________
Education
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TYPE OF SCHOOL |
NAME OF SCHOOL |
LOCATION |
# OF YEARS |
MAJOR & DEGREE |
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COMPLETED |
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High School |
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College/University
Bus. or Trade School
Professional School
Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC |
© 2010 MyOpenJobs, LLC |
1 of 6 |
Criminal History
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR (except any minor traffic violations)? No Yes
If yes, please explain and attach any relevant documentation. _____________________________________________________________________
______________________________________________________________________________________________________________________
Drivers License Information
DO YOU HAVE A VALID DRIVER’S LICENSE? Yes No
Do you have reliable transportation to work (please be specific)? ______________________________________________________________
Driver’s license number: ________________________________________ State of Issue: ______________________
Operator Commercial (CDL) Chauffeur Do you have a clean driving record? Yes No
List any Moving Violations and/or Accidents from the last 3 years: _____________________________________________________________
______________________________________________________________________________________________________________________
Military Service
HAVE YOU EVER BEEN IN THE ARMED FORCES? |
Yes No |
Branch: ________________________________ |
ARE YOU CURRENTLY A MEMBER OF THE NATIONAL GUARD or RESERVES? |
Yes |
No |
Specialty _______________________________________ |
Date Entered __________________ |
Discharge Date ______________________ |
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Work Experience
Please list your work experience for the past 5 years beginning with your most recent job.
If you were self-employed, give firm name. Attach additional sheets if necessary. Attach Resume if applicable.
Name of employer: |
Name of last supervisor |
Employment |
Pay or salary |
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dates |
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Address with city/state/zip: |
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From |
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To |
Final |
Phone: |
Your last job title |
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Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes |
No |
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Name of employer: |
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Name of last supervisor |
Employment |
Pay or salary |
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dates |
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Address with city/state/zip: |
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From |
Start |
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To |
Final |
Phone: |
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Your last job title |
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Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC |
© 2010 MyOpenJobs, LLC |
2 of 6 |
Name of employer: |
Name of last supervisor |
Employment |
Pay or salary |
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dates |
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Address with city/state/zip: |
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From |
Start |
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To |
Final |
Phone: |
Your last job title |
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Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes |
No |
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Name of employer: |
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Name of last supervisor |
Employment |
Pay or salary |
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dates |
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Address with city/state/zip: |
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From |
Start |
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To |
Final |
Phone: |
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Your last job title |
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Specific reason for leaving
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact this employer? Yes No
HVAC/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.
HVAC/R Industry Skills
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 Manufacturers Equipment have you worked with? (Select all that apply)
American Standard |
DelField |
Kold Draft |
Ruud |
Toshiba |
Andover Controls |
Electro Freeze |
Lennox |
Sani Serv |
Trane |
Beverage Air |
Frigidaire |
Liebert |
Seibe |
Traulsen |
Bryant |
Gibson |
Luxaire |
Siemens |
TRUE |
Carrier |
Honeywell |
Manitowoc |
Storlting |
United |
Coleman |
Hoshizaki |
Maytag |
Tappan |
Victory |
Cornecius |
Ice O Matic |
McQuay |
Taylor |
Vogt |
Crystal Tip |
ICEE |
Perlick |
Tekmar |
Westinghouse |
Cummins & Woodward |
Johnson Controls |
Philco |
Thermo King |
York |
Daikin |
Kelvinator |
Rheem |
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What types of Equipment or Systems have you worked with? (Select all that apply)
410A |
Chillers |
Freezers - Commercial |
Oil |
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Split Systems |
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Absorption Systems |
Cold-Plate Systems |
Frozen Beverage Machines |
Ovens - Electric |
Steam |
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Air Dist. Equipment |
Commercial Cooking Equip |
Furnace |
Ovens - Gas |
Trailer Units |
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Air Handlers |
Cooling Towers |
Gas |
Package Units |
Transport Refrigeration |
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Ammonia |
Dehumidification |
Gas Stoves |
Parallel Refrigeration |
Variable Speed Equipment |
Anti-Vibrations |
Dish Washers |
Geo Thermal |
Portable HVAC |
VAV |
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Appliances |
Dry Systems |
Ground Source Heat Pumps |
Propane |
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Ventilation |
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Appliances - Home |
Dry-Coolers |
Heat Pumps |
Puron |
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VRF |
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Bobtail Units |
Dryers - Clothes |
Humidification |
Radiant Heating |
VRV |
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Boilers |
Electric Stoves |
HVAC Equipment |
Reach-Ins |
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Walk-Ins |
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Cascade Refrigeration |
Environmental Test Chambers |
Hydronic |
Recipricating |
Washers - Clothes |
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Central Plants |
Exhaust Systems |
Ice Cream Machines |
Refrigeration |
Water Heaters |
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Centrifugal |
FCB Machines |
Ice Machines |
Refrigerators |
Wet Systems |
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Chilled Water |
Forced Air Systems |
In-Floor |
Rooftop Units |
Window Units AC |
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Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC |
© 2010 MyOpenJobs, LLC |
3 of 6 |
HVAC/R Industry Skills Continued
What types of Parts and Accessories have you worked with? (Select 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 |
Government Projects |
Institutional |
Multi-Family |
Residential |
Cold Storage |
Grocery Stores |
International |
Off-Shore |
Restaurants |
Commercial |
Hospitals |
Light Commercial |
Pools |
Snow Melting |
Floating Floor |
Industrial |
Marine |
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What types of Building Automation or controls experience do you have?
Building Automation |
Controls - Design |
Controls - Programming |
DDC |
Pneumatic controls |
Controls |
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What Job Functions have you performed? (Select all that apply)
Activity Reporting |
Engineer/PE |
Negotiate Contracts |
Retro-Fit |
Advertising (broadcast) |
Estimating |
Operations Manager |
Sales |
Advertising (online) |
Estimator |
P&L |
Sales - In Home |
Advertising (print) |
Executive |
Pipefitter |
Sales - Residential |
Assembling |
Expense Reports |
Piping |
Sales - Retail |
Brazing |
Fabrication |
Plan-O-Grams/Schematics |
Sales - Wholesale |
Budgeting |
Facility Manager |
Plan/Spec |
Sales Management, Area |
Business Development |
Field Supervisor |
Planning |
Sales Management, National |
Call Center Management |
Forecasting |
PLC |
Sales Management, Regional |
Carpentry |
Foreman |
Plumbing |
Sales Manager |
Change Orders |
General Construction |
Policy/Procedure Development |
Sales Training Development |
Channel Development |
General Manager |
Prepare Financial Reports |
Service |
Client Interaction |
Goal Setting |
Presentation Preparation |
Service Agreements |
Client/Account Management |
Heat Transfer |
Preventative Maintenance |
Service Manager |
Cold Calling |
Inspector |
Product Demonstration |
Sheet Metal Worker |
Commission Development |
Installation |
Product Design |
Shipping Coordination |
Computer Literate |
Installation - New Homes |
Product Development |
Shipping/Receiving |
Consultative Selling |
Installer |
Product Testing |
Start-up |
Contract Negotiations |
Instructor |
Production |
Steamfitter |
Contract/Proposal Preparation |
International |
Production Specialist |
Strategic Alliances |
Conventions/Trade Shows |
Journeyman |
Project Management |
Superintendent |
Customer Service |
Lead Generation |
Project Scheduling |
Supervision |
Data Entry |
Lead Management |
Proposal Development |
Take-offs |
Department Forecasting |
Leadership |
Proposal Presentation |
Team Building |
Design/Build |
LEED |
Prospecting/Lead Generation |
Technician |
Designer |
Load Calculations |
Punch List |
Telemarketing - Inbound |
Develop Relationships/Alliances |
Machine Operator |
Purchase Orders |
Telemarketing - Outbound |
Dispatcher |
Maintenance |
Purchasing |
Territory Management |
Drafting |
Maintenance - Apartment |
QA/QC Manager |
Test & Balance |
Draftsman |
Manager |
Quality Assurance/Control |
Thermodynamics |
Driving |
Manufacturer Rep |
Reading Blueprints |
Trainer |
Drywall Repair |
Manufacturing |
Relationship Management |
Troubleshooting |
Electrical |
Market Analysis |
Repair |
Vendor Coordination |
Energy |
Material Handler |
Report Generation |
Welder |
Energy Management |
NATE Certification |
Reporting |
Welding |
Engineer/BSME |
NEBB |
Research |
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What Computer related experience do you have? (Select all that apply)
ACT |
Echelon |
Lon Works |
MS Excel |
SalesLogix |
Approach |
Energy Pro |
Lon-Based Cicron |
MS Office |
Seibe |
AutoCad |
Estimation (software) |
Manual J |
MS PowerPoint |
Trane Duct/Pipe Designer |
Derby |
Goldmine |
Microstation |
MS Word |
WinSales |
Ecco Pro |
Load/Trace 700 |
MS Access |
QuickPen |
Wrightsoft |
Certifications & Licenses
What Certifications & Licenses do you have? (Select all that apply)
(CAMT) Certified Apartment Maint Technician |
HVAC Excellence - Gas Heat |
Journeyman Plumber License |
Certified Energy Manager |
HVAC Excellence - Geothermal |
Master HVAC License |
EPA 608 |
Type I |
HVAC Excellence - Heat Pumps |
Master Plumber License |
EPA 608 |
Type II |
HVAC Excellence - Hydronics I |
NATE - A/C |
EPA 608 |
Type III |
HVAC Excellence - Hydronics II |
NATE - Air Distribution |
EPA 608 |
Universal |
HVAC Excellence - Oil Heat |
NATE - Gas Heat |
HVAC Excellence - A/C |
ICE - Commercial Refrigeration |
NATE - Heat Pumps |
HVAC Excellence - Commercial A/C |
ICE - Light Commercial A/C & Heating |
NATE - Oil Heating |
HVAC Excellence - Commercial Refrigeration |
ICE - Residential A/C & Heating |
Oil Burner License |
HVAC Excellence - Electrical Heat |
Journeyman HVAC License |
Registered Professional Engineer |
Include State and License Numbers for any licenses selected above, if applicable: ___________________________________________________
_________________________________________________________________________________________________________________________
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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.
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Name ___________________________________ |
Name ______________________________________ |
Position _________________________________ |
Position _____________________________________ |
Company ________________________________ |
Company ____________________________________ |
Telephone ( |
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Telephone ( |
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Email Address _____________________________ |
Email Address _________________________________ |
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Name ___________________________________ |
Name ______________________________________ |
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Position _________________________________ |
Position _____________________________________ |
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Company ________________________________ |
Company ____________________________________ |
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Telephone ( |
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Telephone ( |
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Email Address ______________________________ |
Email Address _________________________________ |
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Did you complete this application yourself? |
Yes No |
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If not, who did? _________________________________________________________________________________________________________
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 A T Contractors, LLC creates an actual or implied contract of employment. I understand that, if I accept employment with A T Contractors, LLC, it will be on an at-will basis. This means that either A T Contractors, LLC 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 A T Contractors, LLC. I release A T Contractors, LLC, 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 A T Contractors, LLC 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 A T Contractors, LLC and its employees from all liability arising from such investigation.
Signature of Applicant: ________________________________________________________ Date: _____/______/_________
Print Name: __________________________________________________________________
A T Contractors, LLC 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 A T Contractors, LLC depends solely on your qualifications.
Employment Application supplied for free by hvacagent.com. HVAC Agent is a division of MyOpenJobs, LLC |
© 2010 MyOpenJobs, LLC |
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