HOME ABOUT SERVICES PROJECTS CAREERS CONTACT US Employment Application THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. It is the policy of the company to provide equal employment to all qualified persons without discrimination on the basis of sex, race, color, religion, age, national origin, citizenship, disability, veteran status, or any other status protected under local, state or federal law. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a pre-employment drug screening and/or medical examination. This application will remain active for 3 years. Job Posting Select Posting to Apply for - Select Posting to Apply for - Submit Application - not a specific job Personal Information First Name Middle Name Last Name Home Phone Work Phone Cell Phone Email Address Addresses Current Address 1 Street City State Zip Code Since (Mo/Yr) To (Mo/Yr) Prior Address Prior Address Education School Attended City State Diploma Degree/Cert. Area of Study High School No Yes GED Undergrad School No Yes Grad School No Yes Other School No Yes Employment Information Position Applied For Date You Can Start (yyy-mm-dd) Desired Salary $ Do You Prefer Full-Time Part-Time Either Can you work Weekends Evenings Available M Tu W Th F Sa Su Are you available for shift work? No Yes Not Available Please answer all of the following questions. 1. Are you at least 18 years of age and legally eligible to work for our company in the United States? No Yes If you are under 18 years of age, can you provide required proof of your eligibility to work? No Yes 2. Have you worked for this business before? No Yes If yes, please provide dates and locations. 3. Have you received a description of the job or been made aware of the essential functions of the job for which you are applying? No Yes 4. Do you understand the job requirements? No Yes If no, please explain. 5. Are you on layoff and subject to recall? No Yes 6. Are you currently bound by a noncompetition, confidentiality or trade secret agreement? No Yes If yes, please explain... 7. Have you ever been discharged or asked to resign from a job? No Yes If yes, please explain... 8. Have you ever been convicted of or pled guilty to a felony or crime other than a minor traffic citation? No Yes If yes, please explain... 9. Do any of your friends or relatives, other than spouse, work here? No Yes If yes, state name and relationship... Employment History Are you currently employed? No Yes May we contact your present employer? No Yes Most Recent Employer Employer City State Zip Code Phone Position Held From (m/yyyy) To (m/yyyy) Pay upon leaving Supervisor Duties Reason for Leaving Prior Employer 1 Prior Employer 2 Prior Employer 3 Job-related Skills Please answer the following questions if the position you are applying for requires driving a motor vehicle 1. Do you have a valid driver's license? No Yes If yes, Driver's License Number Date of Issue 2. Have you been convicted of or pled guilty to any traffic-related offense within the past five years? No Yes If yes, please explain... 3. Have you had your driver's license suspended or revoked or had your driving privileges modified by a court of law? No Yes If yes, please explain... 4. Please list all states from which you hold or held a driver's license 5. Please use this space to list any special skills you may have that relate to the position applied for 6. Please list any professional licenses, designations, certifications, etc. that may relate to the position applied for. Include date granted, name of organization, and any other relevant information. References Reference 1 Name Address Telephone Relationship Years Acquainted Reference 2 Reference 3 Reference 4 Resume (Text Version) Copy and Paste a text version of your resume here. Upload File Attach a file to your application submission (Permitted File Types: doc,docx,pdf,txt - Max file size: 1045876 bytes) Applicant Certification Agreement 1. The company and other persons or employers are released from all liability brought forth by any investigation resulting from my submission of this electronic application and the data contained here in. 2. The information in this application is true and complete to the best of my knowledge. Any falsification, misrepresentation, or omission on this application can be cause for denial or termination of employment. 3. If hired, my employment is voluntary, meaning that either party can employment at any time for any reason. Upon acceptance of employment if a position is offered, I agree to abide by all existing and future company rules and regulations. The company reserves the right to change any working agreement as deemed necessary. 4. Any employment offer is contingent open my providing proof of identity and eligibility to work the country of employ. 5. I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely and fully. 6. I understand that by typing my name in the signature box below and submitting this application electronically, this becomes a legal and binding contract. Security Code Type Name in Signature Box: Date: 2021-11-28 12:25:42 You are here: Home Careers Southside Mechanical Services P.O. Box 11210 | Danville, VA 24343 Phone: 434-799-8023 | Fax: 434-799-1716 Email: info@southsidemechanical.com © 2021 Southside Mechanical Services Company, Inc. | All Rights Reserved