Employment Application for Bloom Electric, Air Conditioning, Heating, and Plumbing

8164 Clearfield-Curwensville Highway, Clearfield, PA 16830 / Phone: (814) 765-3140 / Fax: (814) 765-9231 / 24 Hour Service

Employment

Our firm is always pursuing talented special individuals who would like to join our team. We are looking for dedicated, hardworking, self motivated individuals who would like to work in the Clearfield, Jefferson & Centre Counties. If this is you, please fill out and submit the application below.

General Information:

First Name(required)
Last Name(required)
Address(required)
City(required)
State
Zip
Date of Birth (mm/dd/yyyy)
Home Phone(required)
Email(valid email required)
Cell Phone
How do you prefer to be contacted? (Check all the apply)
Home Phone
Email
Cell Phone

Position Information:

Type of employment desired
Part Time
Full Time
Temporary
Any

Please Check Your Area of Interest:

Date available to start

Start Date

Miscellaneous Information:

Are you legally eligible for employment in this country?
(Proof of U.S. Citizenship or Immigration status will be required upon employment.)
Yes No
A criminal records background check is required prior to final approval of any offer.
Have you been convicted of a felony in the last 10 years?
Yes No
If Yes, please explain.
Do you possess a valid Pennsylvania Driver's License?
Yes No
Do you have a vehicle available for your use on a daily basis?
Yes No

Educational Background:

List all college and university experiences. Include High School if relevant.
Schooling Information 1Include Name and Location, Years Attended, Degree Obtained
Schooling Information 2Include Name and Location, Years Attended, Degree Obtained
Schooling Information 3Include Name and Location, Years Attended, Degree Obtained

Employment History:

List your prior employers, assignments or volunteer activities starting with the most recent, including military experience. Explain any gaps in the comment section below.
Please list: (Employer, Address, Phone, Start Date, End Date, Title, Pay Rate, Supervisor Name, Reason for Leaving, May we Contact for a reference, Job Responsibilities)
Prior Work Experience 1
Prior Work Experience 2
Prior Work Experience 3
Additional Work Experience Related Comments

References

List 3 business/work references that are not related to your and are not listed as your supervisor above. Include Name, Phone Number, Relationship, Years Known
Reference 1
Reference 2
Reference 3

Skills and Qualifications

When working with others
what is your most outstanding capability?
List all languages other than English
that you are fluent in and describe level of fluency.
Summarize any other skills,
special training, licenses and/or characteristics
related to the position you are applying for.
List special accomplishments,
publications, awards and such.
List professional, trade, business,
or civic associations of which
you are a member.

Resume Upload

Select File (PDF, DOC, etc.)

Additional Comments

Comments

Certification of Facts

I certify that the information I am providing is true and complete. I understand that if I have misrepresented or omitted relevant information, it may disqualify me for employment or be grounds for dismissal.
Applicant signature
(Please type your first and last name)(required)