Employee Application
Please fill out
the form and it
will be
submitted to
our
Christiansburg
office.
First Name: *
Last Name: *
Address: *
City: *
State: *
Zip: *
Phone Number: *
Cell Number:
E-mail Address: *
Best Time to Reach You: *
Morning
Afternoon
Evening
Night
What is the best way in which to contact you?
Position Applying For: *
Available Start Date: * Select Date
Highest Level of Education: *
Primary School
High School Diploma
Some College
Bachelors Degree
Graduate / Masters Degree
If you earned a college degree, please list the major:
Previous Employer #1:
Dates Employed:
Supervisor Name:
Phone:
Job Duties at Previous Employer:
Previous Employer #2:
Dates Employed:
Supervisor Name:
Phone:
Job Duties at Previous Employer:
May we contact your previous employers regarding your work experience?
Requested Rate of Pay? *
3 References Required- 2 work performance and one personal reference *
Any licenses or certifications you have:
Do you have a valid drivers license, without restrictions? Do you have a safe driving record? *
Drivers License Number- By giving your drivers license number, you give consent to the release of your driving record for review by McGrady-Perdue Heating & Cooling.
Benefits Requested?Health Insurance
Dental
Disability Insurance
Life Insurance
Other
Additional Information you would like us to consider: Include any extra experience you would like us to know.
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