Contact Information

First Name

Last Name

Street Address

City

State

Zip Code

Email Address

Phone

Cell Phone

Job Details

Which position are you applying for? Which position are you applying for? Chimney Repair Apprentice Chimney Technician Customer Service/Sales Fireplace Installer Gas Technician/HVAC Marketing Mason/Bricklayer

Are you 18 years or older? Are you 18 years or older? Yes No

What type of employment are you seeking? What type of employment are you seeking? Permanent. I'm looking to build a stable career. Temporary. I'm looking to build skills to help achieve my future goals. Short Term, Seasonal, or Other...

Have you applied or worked for Full Service Chimney in the past? Have you applied or worked for Full Service Chimney in the past? Yes No

Start Date Available Start Date AvailableImmediately2-4 Weeks1-6 MonthsOther

I certify that I am a US citizen, permanent resident, or a foreign national with authorization to work in the United States? I certify that I am a US citizen, permanent resident, or a foreign national with authorization to work in the United States? Yes No

This is a full-time position. Full Service Chimney operates in a "Team Unit" format, where the absence of any one member could disable a team on that day. Do you have any daytime conflicts that would prevent you from working Monday-Friday 6:30am-6:30pm as needed? This is a full-time position. Full Service Chimney operates in a "Team Unit" format, where the absence of any one member could disable a team on that day. Do you have any daytime conflicts that would prevent you from working Monday-Friday 6:30am-6:30pm as needed? Yes No

If you answered yes, please explain.

Are you available to work weekends? Are you available to work weekends? Yes No

Are you available to work overtime? Are you available to work overtime? Yes No

This position is located in Spring Hill, KS. Do you have a reliable means to come to this location? This position is located in Spring Hill, KS. Do you have a reliable means to come to this location? Yes No Mostly Reliable/Other

If you answered "mostly reliable" or "other", please explain.

The handling of office/field equipment and supplies are a part of this position. Weight of objects you can safely lift without assistance? The handling of office/field equipment and supplies are a part of this position. Weight of objects you can safely lift without assistance? Less than 10 lbs. 10-20 lbs. 20-40 lbs. 40-60 lbs. 60-80 lbs. Other...

Do you require special accommodations in the office or field? Do you require special accommodations in the office or field? Yes No

If yes, please explain

Education

Level of Education Level of EducationHigh School Diploma/GEDSome post high school educationTechnical SchoolCollege Graduate

List any Certification, University or College Degree(s)

Professional History

Have You Served in the US Military? Have You Served in the US Military? Yes No

If Yes, List Branch and Dates of Enlistment

Are you currently employed? Are you currently employed? Yes No

Please list your previous employers, starting with the most recent:

1. Previous Employer / Company Name

Supervisors Name / Phone #

Dates Employed

Reason for Leaving

May we contact this employer? May we contact this employer? Yes No

2. Previous Employer / Company Name

Supervisors Name / Phone #

Dates Employed

Reason for Leaving

May we contact this employer? May we contact this employer? Yes No

References

Do you have references we can contact if needed? Do you have references we can contact if needed? Yes No

Please List Your References Name / Phone / Relationship to each person

Additional applications may be required further along in the hiring process. Additional applications may be required further along in the hiring process. Understood

*I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I acknowledge that the position I am applying for is an “at will” position which I can quit at any time or be terminated from at any time. No one with Full Service, Inc. (dba Full Service Chimney) has authority to change my “at will” status except one of the owners and only if their commitment to do so is in writing. *I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I acknowledge that the position I am applying for is an “at will” position which I can quit at any time or be terminated from at any time. No one with Full Service, Inc. (dba Full Service Chimney) has authority to change my “at will” status except one of the owners and only if their commitment to do so is in writing. I Agree No, I do not agree.

Thank you for considering us for your next career opportunity. Any thing else you would like to add?