Employment Opportunities and Application

Folsom Services, Inc. is an equal opportunity employer.
Please check the position you are applying for:

Journeyman Electrician	Apprentice
Journeyman HVAC	Office Position
Installer	Other

APPLICATION FOR EMPLOYMENT

Date:
Social Security # --

1. Personal Information:

Name

Work Phone

Home Phone

FAX

E-mail

Referred by:

2. Have you ever applied to this company before? Yes No
If "yes", when?
3. Are you employed now? Yes No
4. Salary desired?
5. May we contact the employers listed below? Yes No If not, indicate which
one (s) you do not wish us to contact:

6. Please list any additional information that relates to your ability to perform the job for which you
have applied, such as special training, machine operations, hobbies, languages, etc.:

7. Have you been convicted of a felony within the past 7 years? Yes No
If yes, please explain:

* please note: conviction will not necessarily disqualify applicant for employment.

8. In case of emergency, notify:

Name:
Address:
Phone:

Education:

Education	Name and location of school	Years Attended	Graduated	Course or Major
High School			Yes No
College			Yes No
Trade, Business, Correspondence School			Yes No
Certifications/ License's

Former Employers (list below last three employers, starting with last on first)

1. Employer:
Address:
Telephone #'s:
Job Title: Supervisor:
Dates Employed - From: To:
Duties:

Hourly Rate/Salary - Starting: Final:
Reason for Leaving:

2. Employer:
Address:
Telephone #'s:
Job Title: Supervisor:
Dates Employed - From: To:
Duties:

Hourly Rate/Salary - Starting: Final:
Reason for Leaving:

4. Employer:
Address:
Telephone #'s:
Job Title: Supervisor:
Dates Employed - From: To:
Duties:

Hourly Rate/Salary - Starting: Final:
Reason for Leaving:

References: Please provide the names of three persons not related to you, whom you have known for at least one year.

1. Name:
Address:
Telephone #'s:
Business: Years acquainted:

2. Name:
Address:
Telephone #'s:
Business: Years acquainted:

3. Name:
Address:
Telephone #'s:
Business: Years acquainted:

You can submit this form now, print it and mail it, or fax it to: FAX (407) 892-7864

25 E. 13th Street
St. Cloud, FL 34769
407-892-7317
FAX 407-892-7864
Email: Folsom Services
Map and Driving Directions

Florida State Certified License
EC 1781
CACO 50377