Employment Application

Employment Application
ESGEmailName
THIS APPLICATION SHOULD ONLY BE COMPLETED BY CANDIDATES REFERRED BY ELEVATOR SERVICES GROUP (ESG)!

If you have not been asked by them to complete this form, please do not complete this form!
ESG?

YESNO
Your Name*

First NameLast Name
(Optional) Preferred Name - if you want us to address you with a different name
Address (Where you currently live or will be moving to, not your mailing address)*

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone Number*
What is your preferred method of contact? (Select all that apply)*

PhoneTextEmailOther
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Are you legally authorized to work in the United States? (Please note: We are unable to sponsor or take over sponsorship of an employment Visa at this time)*

YesNo
Please make sure you provide a valid email address that you have access to above. If hired, this will be used to distribute various and required documentation and training. If you do not have a valid email address, please create one before completing this form. You may create a free one using a number of providers including GMail, Hotmail, Yahoo, AOL, iCloud, ProtonMail, and many more.
What position are you applying for?*
Other:*
What is your desired salary range?
Minimum*
Maximum*
Per*

HourYear
*WE ARE CURRENTLY PERFORMING MAINTENANCE ONTHIS APPLICATION. YOU MAY STILL CONTINUE FILLING OUT THIS FORM. PLEASE IGNORE THE FIELD BELOW CALLED "TESTINGFIELD" AND CONTINUE WITH THE REST OF THE APPLICATION. THIS WILL NOT AFFECT YOUR APPLICATON. WE APOLOGIZE FOR ANY CONFUSION.*
TESTINGFIELD
TESTINGFIELD
List Any Certifications/Licenses You May Have

NoneOSHA 30 Construction40-Hour SST62-Hour SSTF60 Fire Guard4-Hour ScaffoldCertified WelderConfined Space AwarenessNYS Elevator MechanicNYS Elevator InspectorNYCDOB InspectorNYCDOB DirectorNYCDOB Elevator MechanicNYCDOB Elevator HelperQEICETCET-SAETDriver's LicenseLearner's PermitCommercial Driver's LicenseOther* (Please Specify Below)
Other Certifications*
Document Upload

This is to help facilitate our on-boarding process. Providing these documents now will allow us to verify their validity and prepare ahead of time prior to your interview. If you do not have these documents available to upload now, please make sure you bring them with you if an interview is scheduled with you. For some positions, we will need to verify the documents prior to starting work.
Upload a copy of the front AND back of your OSHA 30 Construction Card

Cancelof
Upload a copy of the front of your SST Card

Cancelof
NYS Elevator Mechanic License No.*
NYS Elevator Inspector License No.*
NYCDOB Elevator Director License No.*
NYCDOB Elevator Inspector License No.*
NYCDOB Elevator Mechanic License No.*
NYCDOB Elevator Helper Card No.*
Licensing Requirements

As of 2022 New York State & New York City have enacted licensing requirements for elevator mechanics and helpers. The following questions are related to these requirements. If a position is offered we will review these items with you.
Do you have a NEW YORK STATE ID Card or NEW YORK STATE Driver's License?*

YesNoUnsure
Do you have a copy of your Social Security Card? (This will be mandatory to recieve a NYC Helper or Mechanic License)*

YesNoUnsure
If applying for a mechanic position, can you prove any of the following: 1) FOUR (4) Years of experience in the elevator field, 2) Successful completion of a NY State Approved Elevator Apprentice Program OR CET Licensing?*

YesNoUnsure
Are you currently working?*

YesNoChoose Not to Answer
(OPTIONAL) If currently working, would you like to disclose to us why you are looking to leave your current position?
Do you have a resume you would like to submit?*

YesNoAlready Submitted
If you do not upload a resume you will be required to submit employment information below
Upload Resume*

Cancelof
Check Here If you Have No Previous Employment History
Previous Employment*
Total Years of Experience In the Elevator Industry*
Please enter any other relevant skills, experience, or information here:
When are you available to start?*

As Soon As PossibleNeed to provide two-week's notice to current employerDate Specified BelowAfter Date Specified BelowOther (Specify Below)
Date*

MonthDayYear
Date
Other:*
How were you referred to us?*

IndeedGoogleCurrent EmployeeFormer EmployeeOther CompanyESGOther
Employee Name*
Other*
Company*
Self-Identification of Race/Ethnicity

Please read all instructions carefully
We are an Equal Employment Opportunity Employer. It is against Company policy to fail or refuse to hire or discharge any individual, or otherwise to discriminate against any individual with respect to that individual’s terms and conditions of employment, because of such individual’s race, color, religion, sex, gender identity, sexual orientation, disability, marital status, veteran status, national origin or any other protected class. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations. If you choose not to self-identify your race/ethnicity at this time, we may determine this information by visual survey and/or other available information. Race/ethnicity information will be collected in the seven categories identified below and the definitions for each category have been established by the federal government. If you choose to voluntarily self-identify, you may mark only one of the boxes presented below.
Please Choose One:*

Hispanic or Latino: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.Black or African American: a person having origins in any of the black racial groups of AfricaNative Hawaiian or Other Pacific Islander: a person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.White: a person having origins in any of the original peoples of Europe, the Middle East, or North Africa.Asian: a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China,India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.American Indian or Alaska Native: a person having origins in any of the original peoples of North and South America(including Central America), and who maintains tribal affiliation or community attachment.Two or More Races: a person who primarily identifies with two or more of the above race/ethnicity categories.I Do Not Wish To Self-IdentifyOther
Highest Level of Education Obtained*
*If you choose other, you may be required to provide details if required for licensing or certification
Gender*
Any other relevant information you wish to provide?
Interviewer
example@example.com
New Employee Information

Use this form to provide relevant information if the employee above is hired.
Date of Interview*

MonthDayYear
Date
Start Date*

Known (Enter Below)TBD
Estimated Start & Info
Date*

MonthDayYear
Date
Department*
Position*
Office Position*
Other Position*
Pay Rate*
Per:*
Training Required*

NoneOSHA 30Standard OrientationOther (Specify Below)SST (40-Hour)
Training Requirements*
Benefits Arrangement*

Standard EmployeeSupervisorOther (Specify)
Benefits Arrangement*
PTO Arrangement*

Standard EmployeeOther (Specify)
PTO Details*
Will the employee be driving a vehicle owned by LCD?*

YesNoTBD
Will the employee be given a car allowance?*

YesNoTBD
Car Allowance Details*
Other Relevant Info
Form Completed By*
Completed By*
Your Email*
example@example.com
STenzer
example@example.com
RLicht
example@example.com
PLicht
example@example.com
Peter
example@example.com
Should be Empty:

Employment Application

Document Upload

New Employee Information