HVAC Controls Programmer - Sioux City, IA | Job Openings

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Applicant Questionnaire

If employed, what rate or salary do you expect to receive?

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Can you, with or without reasonable accommodation, perform the essential functions of this job?

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(If you have any questions about the functions of the job, please ask the interviewer before answering this question.)

Note: CW Suter complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subjected to a medical examination conducted by a medical professional.

Have you ever applied for a position with this company before?

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Have you ever been convicted of a felony or misdemeanor?

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Note: A conviction will not necessarily disqualify you

Do you have a valid driver's license? *

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Have you been convicted of any moving violations in the past five years?

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Relevant to driving positions only

Do you have any friends, relatives, or acquaintances working for CW Suter?

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Are you willing/able to submit a pre-employment drug screening?

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Have you ever been fired or asked to resign from a job?

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Education

HIGH SCHOOL

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VOCATIONAL

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COLLEGE

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ie. Sept, 2012 - May 2016

Completion Type - College

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Other Education/Vocational Training

Additional Education

List any other education or vocational training you think we should know about here. Please provide dates and locations for each additional item you list.

Describe any specialized training, apprenticeships, licenses, or skills:

Have you received any job-related training in the United States Military?

Yes
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Employment History

Begin with current or most recent employer. Do not exclude any employment. Include any applicable temporary employment. Previous salaries or wages will not be used to determine compensation at CW Suter. You may supplement this application by sending a resume to hr@cwsuter.com

Company Name (1)

Most recent employer

Location

City and State

Name and Title of Last Manager

Phone

Date Employed

Start Date - Termination Date (ie. Feb, 2016 - March, 2019)

Ending Salary

Duties/Responsibilities

Reason for Leaving & Explanation

May we contact this employer?

Yes
No

Company Name (2)

Location (2)

City and State

Name and Title of Last Manager (2)

Phone (2)

Date Employed (2)

Start Date - Termination Date (ie. Feb, 2016 - March, 2019)

Ending Salary (2)

Duties/Responsibilities (2)

Reason for Leaving & Explanation (2)

May we contact this employer? (2)

Yes
No

Company Name (3)

Location (3)

City and State

Name and Title of Last Manager (3)

Phone (3)

Date Employed (3)

Start Date - Termination Date (ie. Feb, 2016 - March, 2019)

Ending Salary (3)

Duties/Responsibilities (3)

Reason for Leaving & Explanation (3)

May we contact this employer? (3)

Yes
No

Please provide any other information that you feel will help us in considering your application for employment.

References

Please list three persons, who are not related to you, who can provide professional references.

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Phone

Relationship/Occupation

Name (2)

Phone (2)

Relationship/Occupation (2)

Name (3)

Phone (3)

Relationship/Occupation (3)

Applicant Acknowledgement & Authorization

PLEASE READ CAREFULLY

ADA Notice/Authorization Confirmation *

I have read the following notice and agree *

I certify that answers given herein are true and complete to the best of my knowledge. I understand that any misleading or incorrect statements may render the application void and would cause for immediate dismissal in the event of employment. I understand and agree that I may resign my employment with CW Suter & Son at anytime for any reason. I understand that full-time employment with CW Suter & Son will be subject to the successful completion of background check and drug screening.

Under the provisions of the Fair Credit Reporting Act U.S.C., Sec. 1681, et seq., notice is herby given that a consumer report of investigative consumer report may be made which may included information pertaining to your employment history, education background, credit worthiness, character, general reputation, driving record, criminal record, personal characteristics, and mode of living, which will be used for employment purposes. An investigation into your worker’s compensation or industrial accident claims background may also be conducted under the guidelines of the Americans with Disabilities Act.

You are further advised under said act that any person who procures or causes to be prepared and investigative consumer report on any consumer shall, upon written request by the consumer within a reasonable period of time after the receipt by him of the disclosure required by subsection 1681(d), shall make a complete and accurate disclosure of the nature and scope of the investigation requested/ This disclosure shall be made in writing and mailed or otherwise delivered to the consumer within five days after the date on which the request for such disclosure was received from the consumer or such report was first requested, whichever is the latter.

You are further advised that if you are denied employment, either wholly or partly, because of information contained in a consumer report as that term is defined in the Fair Credit Reporting Act, that a disclosure will be made to you of the name and address of the consumer reporting agency making such report.

If you require assistance in understanding this notice, you may come in to our offices and complete your application with the help of an individual who can explain this for you.

e-Signature Confirmation *

I understand and agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. *

You are further advised that this online Application for Employment requires an electronic signature to complete submission. Typing your name and date in the designated electronic signature fields on this form constitutes your electronic signature. An electronic signature is the legally binding equivalent to your handwritten signature; it has the same validity and meaning as your handwritten signature.

Electronic Signature *

Date/Time Stamp

712.252.3007

712.252.3007

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HVAC Controls Programmer – Sioux City, IA

PRIMARY JOB FUNCTION

Essential Functions:

Competencies:

Education/Experience:

Benefits:

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Applicant Information

Contact Information

Applicant Questionnaire

Education

Other Education/Vocational Training

Employment History

References

Applicant Acknowledgement & Authorization

712.252.3007

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