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Employment Request
Survivor Fire & Safety Equip., Co., Inc.
General Information
Position Applied For:
Fire Alarm Technician (Inspection and Installation)
Fire Sprinkler Service Technician
Fire Extinguisher/Suppression System Service Technician
Office Administrator
Service Division Manager
Fire Protection Technician - Non Experienced
Date of Application:
How did you hear about us?:
Advertisement
Relative
Inquiry
Website
Friend
Other
Other:
Personal Information
First Name:
Last Name:
Middle Name:
Phone:
Email:
Address:
City:
State:
Armed Forces - Americas
Armed Forces - Europe
Alaska
Alabama
Armed Forces - Pacific
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Northern Mariana Islands
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
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Oregon
Pennsylvania
Puerto Rico
Palau
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Zip Code:
Additional Information
Best time to contact you:
If you are under 18 years of age, can you provide required proof of your eligibility to work?:
YES
NO
Have you ever filed an application with us before?:
YES
NO
Please provide date:
Have you ever been employed with us before?:
YES
NO
Please provide date:
Do any of your friends or relatives, other than spouse, work here?:
YES
NO
Please state name and relationship:
Are you currently employed?:
YES
NO
May we contact your present employer?:
YES
NO
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?:
YES
NO
Proof of citizenship or immigration status will be required upon employment.
Do you have a valid drivers license?:
YES
NO
Please provide your drivers license number:
Date available for work:
What is your desired salary range?:
Are you available to work:
Full Time
Part Time
Temporary
Education
High School (Name):
High School (Course of Study):
High School (# Years Completed):
High School (Diploma/Degree):
Undergraduate (Name):
Undergraduate (Course of Study):
Undergraduate (# Years Completed):
Undergraduate (Diploma/Degree):
Graduate (Name):
Graduate (Course of Study):
Graduate (# Years Completed):
Graduate (Diploma/Degree):
Other (Name):
Other (Course of Study):
Other (# Years Completed):
Other (Diploma/Degree):
Work Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities.
Work Experience (1)
Employer:
Address:
Phone Number:
Starting Job Title:
Present Job Title:
Supervisor:
Reason For Leaving:
Date Employed (Start):
Date Employed (End):
Starting Salary:
Ending Salary:
May We Contact Supervisor?:
YES
NO
Work Performed:
Work Experience (2)
Employer:
Address:
Phone Number:
Starting Job Title:
Present Job Title:
Supervisor:
Reason For Leaving:
Date Employed (Start):
Date Employed (End):
Starting Salary:
Ending Salary:
May We Contact Supervisor?:
YES
NO
Work Performed:
Work Experience (3)
Employer:
Address:
Phone Number:
Starting Job Title:
Present Job Title:
Supervisor:
Reason For Leaving:
Date Employed (Start):
Date Employed (End):
Starting Salary:
Ending Salary:
May We Contact Supervisor?:
YES
NO
Work Performed:
Comments: Include explanation of any gaps in employment.
Describe any specialized training, apprenticeship, skills, licenses, CDL's and extra-curricular activities.
List professional, trade, business or civic activities and offices held.
Additional Information
References
Name (1):
Phone Number (1):
Best Time to Call (1):
Occupation (1):
Name (2):
Phone Number (2):
Best Time to Call (2):
Occupation (2):
Name (3):
Phone Number (3):
Best Time to Call (3):
Occupation (3):
Note To Applicants
Do not answer this question unless you have been informed about the requirements of the job for which you are applying.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given and received by applicant.
YES
NO
Applicants Statement
I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision including drug testing.
This application for employment shall be considered active for a period of time not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such as change is specifically acknowledged in writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
