Miller’s Heating & Air provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Miller’s Heating & Air complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, workplace conduct, compensation and training.

Personal Information

Full Name

Address

Phone

Referred By

Employment Desired

Position

Date you can start

Salary Desired

If so, when?

Education History

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Special Certifications, Training and Skills

Certifications

Subject of study, work, or special training

U.S. Military Service
YesNo

If Yes, Rank?

Employment History

Show your last three Employers beginning with the most recent.

Employer #1

Name of Employer:

Started:

Left:

Employer Address:

Salary:

Position at Employer:

Reason for leaving:

Employer #2

Name of Employer:

Started:

Left:

Employer Address:

Salary:

Position at Employer:

Reason for leaving:

Employer #3

Name of Employer:

Started:

Left:

Employer Address:

Salary:

Position at Employer:

Reason for leaving:

References

Reference #1

Name

Address

Business

Years Known

Reference #2

Name

Address

Business

Years Known

Reference #3

Name

Address

Business

Years Known

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