All American Appliance, Inc. Employment Application
(online submission)

Please fill out online and press the Submit button at the bottom of the page. Remember
to press the Reset button if you would like to clear the form.

*Indicates Required Field

Date:
Last Name:
First Name:
Address:
City: State:  
Zip:
Home Ph.
Work Ph.
Cell/Pager
Employment Position Information:
___________________________________________________________
Position Applied For:
 
Tech

Are you eligible to work in the U.S.?

Yes No
Are you at least 18 years of age?
Yes No
*Have you ever been convicted of a crime, felony or misdemeanor? Yes No
*My initials here indicate that this statement as to conviction for crime, felony or misdemeanor is true and correct.

*(Required Answer)
If yes, please explain:
What towns or zip codes are you willing to work in?
Why are you interested in employment with our company?
Describe your professional appliance repair experience
Briefly describe your educational background:
Employment History: (List your most current employment first)
___________________________________________________________
1.
Dates of employment: From: To:
Name of employer:
Supervisor/Manager name: Phone:

Duties:
Reasons for leaving:
*Can we contact your supervisor? (Required to Type in Box either "Yes" or "No")
*(Required Answer)
 
2.
Dates of employment: From: To:
Name of employer:
Supervisor/Manager name: Phone:

Duties:
Reasons for leaving:
*Can we contact your supervisor? (Required to Type in Box either "Yes" or "No")
*(Required Answer)
 
3.
Dates of employment: From: To:
Name of employer:
Supervisor/Manager name: Phone:

Duties:
Reasons for leaving:
*Can we contact your supervisor? (Required to Type in Box either "Yes" or "No")
*(Required Answer)

Personal References

Please list three personal references, not related to you, whom you have known for at least one year:
 
1. Name: Phone: Relationship:
2. Name: Phone: Relationship:
3. Name: Phone: Relationship:
*My initials here indicate that the above statements are true and correct. *(Required Answer)