"Honest & Reliable Service" At Affordable Rates!

(813) 920-1760 or (813) 920-1779
Over 15 Years Experience
Licensed · Insured · Bonded · CAC058156

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Kassel's Appliance & A/C Repair, Inc.
Odessa, FL 33556
(813) 920-1779

Online Employment Application Form 

       "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements concerning my previous employment and any pertinent information they my have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreegment for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized comapny representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

May we contact? - PE#2

*Before submitting your online employment application, please review your application and make sure all fields are correctly filled in.

Name (First, Middle & Last)
Date
Desired Salary
Street Address
City
State
Zip Code
How Long At Address?
Home Phone
Cell Phone
Social Security Number
Date of Birth
Marital Status
No. of Dependents
Date Available to Begin Work
If time at current address is less than 3 years, please fill in previous address and how long you lived there for.
Are you over 18 years of age?
Yes
No
Are you eligible to work in the United States?
Yes
No
If yes, issued by what state?
If yes, driver's license number.
Do you have a valid driver's license?
Yes
No
Do you have reliable transportation to and from work?
Please describe your driving record.
Have you ever been arrested?
Yes
No
If yes, for what?
What is the last grade that you successfully completed in school?
Do you have a college education?
Yes
No
If yes, what courses did you take?
Do you have experience in any of the following?
A/C & Heat
Appliances
If yes to any of the above, please describe.
Do you have any other work experience or certifications?
Current or most recent employer
*Address
*Phone Number
*Dates employed (From - To)
Duties Performed
Reason for leaving
May we contact?
Yes
No
Immediate Supervisor
Immediate Supervisor- PE
Reason for leaving - PE
Duties Performed - PE
Dates employed (From - To) - PE
Address- PE
Previous Employer
Phone Number- PE
May we contact? - PE
Yes
No
Immediate Supervisor  - PE#2
Reason for leaving  - PE#2
Duties Performed  - PE#2
Dates employed (From - To)-- PE#2
Phone Number - PE#2
Address - PE#2
Previous Employer - PE#2
Yes
No
Name - Personal Ref
Phone Number - Personal Ref
Relationship- Personal Ref
Address- Personal Ref
Applicant's Electronic Signature (By typing in your name this will be used as your online signature)
Date - App
Name
Phone Number
Relationship
Address

Employment History

Personal Reference

General Information

Employment Application Form

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