Nashville, IL Carbondale, IL Effingham, IL Paris, IL

Full-Time Part-Time Seasonal Career

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Type of School Name of School and Complete Mailing Address Years Major or Degree
High School
College, Bus., or Trade School
Professional School

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Are you legally eligible to work in the United States:
Do you have a drivers license?

Have you had any accidents in the past 3 years?

Have you had any moving violations in the past 3 years?

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Previous Employment (list up to 3)

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Experience, Skills, and Qualifications

Equipment # of Years
Commercial Heating and Cooling
Commercial Electrical
Commercial Cleaning Equipment
Woodworking Equipment
Sheet Metal Equipment
Clutch Rebuilding
Differential Rebuilding
Body Work
Frame / Axle Straightening Equip.
Electrical Rebuilding Equipment
Diesel Injection Equipment
Electric Welder
Oxyacetylene Welder
Paint Spray Gun
Wheel / Tire Balance Machine
Tire Recapping Mold
Engine Dynamometer
Chassis Dynamometer
Equipment/Skill # of Years
Keyboarding WPM
Shorthand WPM
MS Word
MS Excel
MS Powerpoint
Multiline Phone
Dictating Machine Trans.
Foreign Languages: (List Each One)


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Applicant Signature

Please read and understand this statement before signing your application

The information I have provided in this Application for Employment is true, correct and complete. False, incomplete or misrepresented information of any kind will be sufficient cause for my application to rejected or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer to contact and obtain information about me from previous employers, educational institutions and "references" I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my Application, I waive all rights and claims. I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment and all other persons, corporations or organizations who provide information for this purpose.

This application will expire in 90 days. After that date, unless otherwise notified. I understand that my status as an applicant will end. I may re-apply for employment in the future by completng a new application.

This application is not an employment agreement. If I accept an offer of employment I understand the employer may terminate my employment at any time, with or without cause and without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into any employment agreement with terms contrary to the foregoing and then only in writing signed by such officer.

By signing this application, you have given PlaceSmart Agency permission to share your information and/or application with other employers.

I understand that by typing my name in the box below and clicking submit in lieu of a handwritten signature that I am submitting this application with an electronic signature.

I fully understand and accept all terms and conditions in the above statement.

You may sign this document electronically by typing your name (as given on this application), into the box below.

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