Miller Refrigeration Job Application Form

Section 2

Employment History
Present or Most Recent Employment

(If now unemployed give details of last employer)
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Start Date:
Currently Employed?
Brief description of duties:
Last day of Service

MonthDayYear
(If no longer employed)
Reason for leaving
(If no longer employed)
Previous Employment (most recent employer first). Please cover the last 10 years and state nature of business - if not public sector
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Held
Summary of duties:
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving
Name of Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position Held
Summary of duties:
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving

Section 3

Education History
Colleges, Universities, & Trade Schools

Please list School Name and Course with qualifications/grades obtained.
Name of School:
Name of School
Years Attended:
Number of years completed.
Did you graduate?
Degree Obtained:
Name of School:
Name of School
Years Attended:
Number of years completed.
Did you graduate?
Degree Obtained:
Name of School:
Name of School
Years Attended:
Number of years completed.
Did you graduate?
Degree Obtained:

Section 4

Technical Qualifications and Other Development
Professional, Technical or Management Qualifications
Professional, Technical or Management Courses Taken
Membership of any Professional or Technical Associations
Please indicate level of Membership
Training and Development
Please give details of any training and development courses or non-qualifications courses which support your application.
Formal and On-the-Job training
Please give details of any On-the-Job training which support your application.
Abilities, skills, knowledge and experience
Please use this section to explain in detail how you meet the requirements of the job description. If you are, or have been, involved in voluntary/unpaid activities, please also include this information.

Section 5

References
Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your references are.
Reference 1
Name
Position (Job Title)
Work relationship
Organization
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
May we contact this employer?
Reference 2
Name
Position (Job Title)
Work relationship
Organization
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
May we contact this employer?

Section 6

Declaration
B. Statement to be Signed by the Applicant

Please complete the following declaration and sign it in the appropriate place below. If this declaration is not completed and signed, your application will not be considered.

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature
Date

MonthDayYear
Date
Candidates selected for interview will normally be notified within 24-48 hours of the closing date. Unfortunately, applicants who do not hear from Miller Refrigeration, Inc. must conclude that their application has been unsuccessful on this occasion.

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Job Application Form

Section 1

Section 2

Section 3

Colleges, Universities, & Trade Schools

Section 4

Section 5

Reference 1

Reference 2

Section 6