Personal information you provide may be used for secondary purposes [Privacy Law § 1504(1)(m)].

1. What position are you applying for?
   
   
   
2. Please provide us with the following information which will enable us to contact you:

   Name:

   Address:

   City:            State:         Zip Code:

   Phone:         E-mail:   

    

3. List your Work History. Provide a complete description.  BE SPECIFIC.  Start with your most recent job.  BE CERTAIN TO INCLUDE SERVICE IN THE ARMED FORCES.  Indicate any changes in job title under same employer as a separate position.:
   Company: Address: Phone: Supervisor: Position: Dates of Employment: Reason for Leaving: Duties:                  Company: Address: Phone: Supervisor: Position: Dates of Employment: Reason for Leaving: Duties:

       Company: Address: Phone: Supervisor: Position: Dates of Employment: Reason for Leaving: Duties:                  Company: Address: Phone: Supervisor: Position: Dates of Employment: Reason for Leaving: Duties:

4. List any organizations you belong to (or have belonged to) and any job-related honors or awards you have received:
    

5. List your education history (including GED Equivalency):
   

6. List any additional training or education you have had which is not covered above, such as vocational school, correspondence courses, service schools, in-service training, or volunteer work which you feel is relevant to the job or jobs for which you are applying.  Also include relevant licenses or certificates.:
   

7. Please provide name, address and contact number for two references that we may contact:
   Name Address Phone Name Address Phone

8. Do you have access to a car? (For some positions, a vehicle is required.) 

9. Do you have a valid driver’s license?  

10. Are you over age 18?  

11. Are you a U.S. citizen, or do you have an entry permit which allows you to work?  

12. Do you have any criminal charges pending against you?  

    If yes, please explain:

13. Availability:

       What hours are you NOT available to work? 

       What days are you NOT available to work? 

Applicant Verification, Authorization & Release Statement

By selecting the Submit Application button I certify that the information provided by me in this application of employment at Air Maintenance, Inc. (“AMI”) is true and complete to the best of my knowledge. I understand that if I am employed at AMI, any false statements or omissions in the application can lead to immediate dismissal, and I agree that AMI shall not be held liable in any respect if my employment is terminated for that reason.

AMI is hereby authorized to verify the information I have supplied and to conduct any investigation of my personal history and/or credit and financial records, employing investigative or credit agencies or bureaus of AMI’s choice subject to the provisions of the Fair Credit Reporting Act. I understand that, within a reasonable period, I may make a written request for detailed information concerning such investigation.

I consent to submit to the following types of testing for drugs, alcohol and/or inhalants pursuant to AMI’s requirements: pre-employment, post-accident, periodic, random testing or testing based on reasonable cause to believe a person is under the influence of controlled substances during work hours while on AMI time.  I authorize AMI or any selected hospital, clinic, laboratory, or medical review officer/organization to conduct the tests, analyze the results and furnish each other with results and information about my test results.  I agree that AMI may deny me employment if the results of the tests are considered unfavorable by AMI.  I agree to notify AMI, within five days, of any criminal conviction for a drug related offense incurred while employed with AMI.

I hereby authorize any previous employers, companies, schools, and any persons identified in the application to give any information requested by AMI regarding my previous or current employment and job performance, character, and qualifications.

I hereby agree to release and hold harmless AMI, and any current or previous employer, company, school, or person identified in the application from any liability resulting from the information gathered through the drug testing or verification and inquiry of my application. I hereby agree to indemnify AMI for any costs associated with the defense or liability of any claim against AMI resulting from any false statements or omissions in my application.  I understand and agree that, if hired, my employment is at will, for no definite period of time and may be terminated at any time without prior notice and without cause.

This application shall lapse 60 days after the date of applicant’s submission and applicant shall have to complete and submit a new application to be considered for employment.