<p> Employment Application</p><p>Applicant Information</p><p>Full Name: Date: Last First M.I.</p><p>Address: Street Address Apartment/Unit #</p><p>City State ZIP Code</p><p>Phone: Email</p><p>Date Available: Social Security No.: Desired Salary:$</p><p>Position Applied for:</p><p>YES NO YES NO Are you a citizen of the United States? If no, are you authorized to work in the U.S.?</p><p>YES NO Have you ever worked for this company? If yes, when?</p><p>YES NO Have you ever been convicted of a felony?</p><p>If yes, explain:</p><p>Education</p><p>Years EDUCATION Name and location of school Degree Received Subject/Major Attended</p><p>High School</p><p>College or University</p><p>Trade, Business, or Correspondence School</p><p>References</p><p>Please list three professional references. Full Name: Relationship: Company: Phone:</p><p>Full Name: Relationship: Company: Phone:</p><p>Full Name: Relationship: Company: Phone:</p><p>Previous Employment</p><p>Company: Phone:</p><p>Address: Supervisor:</p><p>Job Title: Starting Salary:$ Ending Salary:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO May we contact your previous supervisor for a reference?</p><p>Company: Phone:</p><p>Address: Supervisor:</p><p>Job Title: Starting Salary:$ Ending Salary:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO May we contact your previous supervisor for a reference?</p><p>Company: Phone: Address: Supervisor:</p><p>Job Title: Starting Salary:$ Ending Salary:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO</p><p>May we contact your previous supervisor for a reference? Military Service</p><p>Branch: From: To:</p><p>Rank at Discharge: Type of Discharge:</p><p>If other than honorable, explain:</p><p>Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment is at-will and can be terminated, with or without cause, with or without notice, at any time, at either my or the company’s discretion. I understand that all information on this job application is subject to verification and I understand that a criminal background check and drug test may be conducted. I hereby authorize any person, educational institution, or company I have listed as a reference on my employment application to disclose in good faith any information they may have regarding my qualifications and fitness for employment. I will hold Catawba Mechanical Services, Inc., any former employers, educational institutions, and any other persons giving references free of liability for the exchange of this information and any other reasonable and necessary information incident to the employment process. </p><p>Catawba Mechanical Services, Inc. is an equal opportunity employer and does not discriminate on the basis of race, color, gender, religion, age, sexual orientation, national or ethnic origin, disability, marital status, veteran status, or any other protected group status under federal, state or local law. Catawba Mechanical Services, Inc. promotes affirmative action for minorities, women, disabled persons and veterans.</p><p>Signature: Date:</p>