betlem-west-careers-employment-application-form

APPLICATION FOR EMPLOYMENT

Equal Employment Opportunity Policy

Betlem Residential Heating & Air Conditioning is deeply committed to a policy of equal employment opportunity for all its job applicants and employees. We seek to employ qualified persons in all job classifications and to administer all personnel actions affecting our employees without discrimination on the basis of race, color, religion, sex, pregnancy, age, national origin, sexual orientation, gender identity, political ideology, ancestry, or genetic information. Individuals with a disability, disabled and other protected veterans and any other characteristic protected by applicable law will be given the fullest consideration for employment in positions for which they are qualified. We also are committed to making reasonable accommodations for qualified individuals with a disability as well as abiding by any and all state and local laws, which, in addition to the above, prohibit discrimination in any form.

APPLICATION DIRECTIONS

Complete all sections of the application, even if the entries duplicate information in your resume or other documentation. Resumes and other documents ARE NOT accepted in place of the information requested on this application. In order to be considered valid, all sections must be completely filled out. Be sure to sign and date the form.

Form fields with an asterisk “*” and/or "Required” must be filled out.

PERSONAL INFORMATION

Last Name *

First Name, Middle Initial *

Day Phone Number *

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Cell Phone Number

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks.

Present Address (Street, Apartment Number) *

City, State, Zip *

Personal Email *

How long have you lived at this address? *

Previous Address (Street, Apartment Number) if at present address less than 3 years:

City, State, Zip

How long did you live at this address?

EMPLOYMENT DESIRED

Position for which you are applying:

HVAC Service Technician HVAC Installation Technician HVAC Apprentice Residential Comfort Advisor / Light Commercial Account Manager Residential Customer Service Representative

ATTACH RESUME

Salary desired *

Hourly Weekly Annually

How did you learn of this opening?

Advertisement (Type)

Referred by

What type of work are you seeking?

Check options

Full-time Part-time Regular Temporary

If Part-time:

Days Hours

If Temporary:

Weeks Months

WORK HISTORY

(List most recent job first) Be sure to account for all information requested in the Work History section of this application (be sure to include the last seven years of employment history).

May we contact your current employer? *

Yes No

Name and address of Employer *

Term of Employment Dates: From /To: *

Phone Number *

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Position *

Job Responsibilities *

Reason for Leaving *

Name and Address of Employer (First Previous)

Term of Employment Dates: From /To

Phone Number

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Position

Job Responsibilities

Reason for Leaving

Name and address of Employer (Second Previous)

Term of Employment: From /To

Phone Number

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Position

Job Responsibilities

Reason for Leaving

Name and address of Employer (Third Previous)

Term of Employment: From /To

Phone Number

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Position

Job Responsibilities

Reason for Leaving

Name and address of Employer (Fourth Previous)

Term of Employment: From /To

Phone Number

Please enter your phone number as such: 2223334444. No hyphens, periods or parentheses marks. This is a required form field.

Describe and list any certifications, special skills, experience, military service, education, or training you consider especially applicable to the position for which you are applying.

OTHER INFORMATION

Were you previously employed by our parent company, EMCOR, or any of its subsidiaries? *

Yes No

If yes, where and when?

Are you subject to a non-competition agreement or other agreement that would preclude or restrict your employment with Betlem? *

Yes No

If yes, please describe below:

Are you 18 years of age or older? *

Yes No

(If under 18 years of age, applicant will be required to submit a work certificate if required by the State in which the applicant will be employed, if offered employment.)

If offered employment by Betlem, would you be legally eligible to begin employment immediately? *

Yes No

Will you need any immigration-related support or sponsorship from Betlem in order to begin or continue employment *

Yes No

If “Yes”, please state the type of sponsorship required (if known)

DRIVING INFORMATION

(If applying for a job that requires driving) Do you have a current and valid state drivers’ license? *

Yes No

PRE-EMPLOYMENT STATEMENT

I hereby certify that the information provided on this application (and accompanying resume or other documentation, as applicable) is true and complete to the best of my knowledge. I understand that any falsified information or significant omissions in the hiring process may disqualify me from further consideration for employment and may be considered justification for termination if discovered at a later date.
I understand that my employment is at will, and that I have no express or implied contract with the Company concerning the terms and conditions of my employment. Both the Company and I have the right to terminate the employment relationship at any time, with or without cause, and with or without notice. I further acknowledge that I have not relied, or will not rely, upon any representations to the contrary, either in accepting employment with the Company or in continuing my employment with the Company. Also, the Company has the right to modify any policies adopted by the Company, and such policies do not create any contractual commitments by the Company.
I understand that according to federal law all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and U.S. citizen status or, if aliens, their legal authorization to work in the U.S. As a consequence, I understand that any offer of employment would be contingent on my ability to produce the required documentation within the time period required by law.
I understand that the Company may not ask me or require me to disclose my current or past salary, wages, benefits or other compensation if I am applying for a job working in the following jurisdictions as of the dates indicated: Puerto Rico (3/8/17), Oregon (10/6/17), New York City (10/31/17), Albany, NY (11/9/17), Delaware (12/14/17), California (1/1/18), San Francisco, CA (7/1/18), Massachusetts (7/1/18), Vermont (7/1/18), Westchester County, NY (7/9/18), Connecticut (1/1/19), Hawaii (1/1/19), Suffolk County, NY (6/30/19), Maine (9/17/19) and Cincinnati, OH (3/12/20), Alabama (9/1/19), Colorado (1/1/21), Illinois (9/29/19), Maine (9/17/19), Kansas City, MO (10/31/19), New Jersey (1/1/20), New York State (1/6/20), Toledo, OH (7/4/20), Washington. However, in the following jurisdictions, the Company may verify my past compensation as follows: (1) if I voluntarily disclose it (New York City, Massachusetts); (2) after an offer with compensation is made (Oregon, Albany); (3) after a salary is negotiated and an offer made (Puerto Rico, Massachusetts); or (4) after an offer is made and accepted (Delaware).

Signature

Date of Application

Betlem Residential Application for Employmen3
Revision Date: 12-7-2023