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New England Air Systems Inc. - Application for Employment

Applicant Information:

Name:
Date:
Address:
City, State, Zip Code:
Home Phone:
Social Security No.:
Date available:
Position for which you are applying:
How did you hear about New England Air Systems?
Licenses/Certifications you currently hold:
Minimum Hourly or Weekly Salary Requirement:

Education:

College:
Address:
Course of Study:

Post-Secondary Trade
or Technical Institution:

Address:

Course of Study:

High School:

Address:

Course of Study:

Training:

Training/skills relating to position for which you are applying
(including computer software):

Additional Information:

Are you available to work:
     Days Evenings Overnight Weekends Holidays
Are you legally authorized to work in the United States? Yes No
Are you 18 years or older? Yes No
Are you a veteran? Yes No
     Branch:
     Rank/Duties at Separation:

     (Please note that a copy of your DD214 form must be submitted to NEASI within three weeks of hire.)
Have you ever been convicted of a criminal offense? Yes No

	If yes, explain:
	Date:
	Place:
	Nature:

Have you previously applied for or been employed by NEASI? Yes No
     If yes, when:
Do any members of your family work for NEASI? Yes No
     If yes, who and in what capacity?:

Experience:

Please list previous employers in the last 10 years, starting with the most recent:

1)	Name:
	Address:
	Supervisor:
	Title/Duties:
	Salary:
	Start Date:	End Date:
	Reason for Leaving:

2) Name:

Address:

Supervisor:

Title/Duties:

Salary:

Start Date: End Date:

Reason for Leaving:

3) Name:

Address:

Supervisor:

Title/Duties:

Salary:

Start Date: End Date:

Reason for Leaving:

4) Name:

Address:

Supervisor:

Title/Duties:

Salary:

Start Date: End Date:

Reason for Leaving:

References:

Please list three (3) business related references:

1)	Name:	Company:
	Address:
	Title:	Telephone Number:

2) Name: Company:

Address:

Title: Telephone Number:

3) Name: Company:

Address:

Title: Telephone Number:

New England Air Systems, Inc. (NEASI)

Acknowledgment/Consent for Information Access

The information provided in this application for employment (and accompanying resume, if any) is true, correct and complete. I understand that a misstatement or omission of fact on this application may disqualify me from further consideration for employment or, if employed, result in my immediate dismissal if discovered at a later date.

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.

I understand that my employment is at will. I understand that my employment can be terminated, with or without cause, at any time at the discretion of the Company or myself. I understand that no NEASI Manager other than the President of the Company has any authority to enter into any agreement contrary to the foregoing or to make any oral assurance or promise of continued employment.

I authorize individuals named as references, my current employer, previous employers, co-workers, individuals, educational institutions and organizations named in this application (and accompanying resume, if any) to provide information and confirmation regarding my work history, educational background and character to NEASI to assist in its consideration of my application for employment. I hereby release these individuals from any liability regarding information provided.