EMPLOYMENT APPLICATION

It is the policy of Prestige Fire Protection, Inc. that applicants for employment are recruited, selected and hired on the basis of individual merit and ability with respect to positions being filled and potential for promotions or transfer which may be expected to develop. Applicants are recruited, selected and hired without regard to age, race, creed, color handicap, marital status, sex, national origin, ancestry, sexual orientation, arrest or conviction record, or veteran status.

Date:
First Name:
Middle Inital:
Last Name:
Social Security Number:
Present Address:
City:
State:
Zip:
Telephone Number:
Position Applied For:
	Full Time Part Time Temporary
Pay Desired:
Available Start Date:
How were you referred to Prestige Fire Protection, Inc.?
Have you ever worked for Prestige Fire Protection, Inc.?
If yes, when?
Do you have friends or relative employed by Prestige Fire Protection, Inc.?
If yes, who?

EDUCATION:
Please list your educational experience.
Name/Location of School Did you graduate?
Subjects Studied or Degrees Obtained.
Describe any specialized training, apprenticeship, skills, or foreign language skills.
What job-related organizations do you belong to? (Do not include those pertaining to race, religion or national origin.)
Please describe any additional relevant information that would be helpful in considering your qualifications.

EMPLOYMENT AND EXPERIENCE:
Please list the employers you have worked for, beginning with the most recent.

Present or Last Employer:
City:
State:
Zip:
Job Title:
Name of Supervisor:
Nature of Work Performed:
Dates Employed: From (month/year)
To (month/year)
Starting Base Salary/Wage:
Final Base Salary/Wage:
Reason for leaving:
Can we contact this employer?	Yes No

Present or Last Employer:
City:
State:
Zip:
Job Title:
Name of Supervisor:
Nature of Work Performed:
Dates Employed: From (month/year)
To (month/year)
Starting Base Salary/Wage:
Final Base Salary/Wage:
Reason for leaving:
Can we contact this employer?	Yes No

Present or Last Employer:
City:
State:
Zip:
Job Title:
Name of Supervisor:
Nature of Work Performed:
Dates Employed: From (month/year)
To (month/year)
Starting Base Salary/Wage:
Final Base Salary/Wage:
Reason for leaving:
Can we contact this employer?	Yes No


READ BEFORE SIGNING:
I certify that the information given in this application is true and correct to the best of my knowledge, and I understand that falsification of this information or unsatisfactory references are grounds for rejection or dismissal. I authorize representatives of my past employers, educational institutions or other references to give the employer any and all information concerning my previous employment, education and any other pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing this information. If I am employed, I understand that my employment is at will employment, meaning that my employment is for no fixed duration and can be terminated by me or the employer at any time with or without cause or notice. I understand that no representative of the employer has the authority to make any contrary agreement and I understand that I may not rely on any other verbal or written agreements or promises that have been made to me. I understand that employment with Prestige Fire Protection, Inc. is pursuant to terms and conditions established by Prestige Fire Protection, Inc. which are subject to change without notice. Further, I represent that I am genuinely interested in working in the position for which I am applying and I am making this application for no other purpose. I certify I have read and understand the above verifications.
Typing your name in the "Signature" box indicates that you argee to the section above.
Signature:
Date: