Tevis Oil • Modern Comfort Systems

ONLINE APPLICATION
How did you hear about us? Billboard Newspaper Radio Referral Other
Last Name:	First Name:		Middle Name:
Street:
City:	State:		Zip:
How long at current address:
Phone number:
Are you under age 18:		Yes No
Is applicant eligible to work in the US and able to provide proof of eligibility?		Yes No
Have you ever applied to, or worked for this company before:		Yes No
If so, where:
If so, when:
When are you available to start work:

Do you have a high school education or equivalent:	Yes No
If no, what was the last grade completed:
Have you attended any vocational schools:	Yes No
If yes, what was your course of study:
Vocational school attended:
Have you attended college:	Yes No
If yes, what was your course of study:
College attended:

Have you ever been convicted of a crime, other than a minor traffic violation:	Yes No
If yes, please explain:
A conviction record will not necessarily disqualify your from employment

POSITION APPLYING FOR:
Driver Service Tech Other
If other, which position:

Drivers/Service Techs Only
Do you have a drivers license:	Yes No
Driver's license Number:
State of issue:
Have you had any accidents within the past three years	Yes No
How Many?:
Have you had any moving violations within the past three years?:	Yes No
How Many?:
Date Of Birth(Answer Only If Applying For CDL Driver Position):

EMPLOYMENT HISTORY
Name of Employer:
Job Title:
Name of Last Supervisor:		Phone:
Street:
City:	State:	Zip:
Salary:	Dates of Employment:
Reason For Leaving:

Name of Employer:
Job Title:
Name of Last Supervisor:		Phone:
Street:
City:	State:	Zip:
Salary:	Dates of Employment:
Reason For Leaving:

Name of Employer:
Job Title:
Name of Last Supervisor:		Phone:
Street:
City:	State:	Zip:
Salary:	Dates of Employment:
Reason For Leaving:
May we contact your present employer? Yes No

It is unlawful in the state of MD to require or administer a lie detector test as a condition of employment or continued employment. Any employer who violates this law shall be subject to criminal penalties and civil liability.

By submitting this application, I agree to the terms and conditions.