Employee Information

Please fill out the form below. When done, submit your cover letter and resume to (need email address)

Name *
Name
Address
Address
Best Phone to Reach You
Best Phone to Reach You
Type of Work Desired
Are you legally eligible for employment in this country?
If you are under 18, can you furnish a work permit?
(Proof of U.S. citizenship or immigration status will be required upon employment.)
Have you ever been employed by Air Assurance Company before?
Type of employment desired?
Have you ever been convicted of a felony?
Referral
Referral Source
Education and Training
Graduated
Vocational
Graduated
College
Graduated
Graduate
Graduated
If skilled craft, are you registered in an apprenticeship program?
Last Employer
Address 1
Address 1
Phone 1
Phone 1
May we contact for reference?
Employer 2
Address 2
Address 2
Phone 2
Phone 2
May we contact for reference?
Employer 3
Address 3
Address 3
Phone 3
Phone 3
May we contact for reference?