Digital Employment Application (Maintenance)
Aquatech Management of Long Island, INC
First name *
Your answer
Middle initial
Your answer
Last name *
Your answer
Cell phone *
Use this format (555) 555-5555
Your answer
Emergency Contact *
First and Last Name
Your answer
Emergency Contact *
Relationship
Your answer
Emergency Contact Phone Number *
Use this format (555) 555-5555
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Social Security Number *
Your answer
Cell phone service provider *
Email address *
Your answer
Mailing Address *
Number and Street only
Your answer
Address2
If applicable
Your answer
Town *
Your answer
Zip Code *
Your answer
Other certifications (WSI, etc)
Separate each by a comma
Your answer
Date you are available to start work *
MM
/
DD
/
YYYY
Present or Last Employer
Your answer
List any previous experience that may relate to this position
Your answer
Salary at current or last position
Indicate /year, /day or /hr
Your answer
University or High School you will be attending this Fall *
Use n/a if not applicable.
Your answer
When are you due back on Campus?
If hired by Aquatech, you will be asked to work past labor day. If this is not possible due to college commitments indicate when you are expected back on campus
MM
/
DD
/
YYYY
Last day you will be available to work *
Use Dec 31st if you have no educational conflicts
MM
/
DD
/
YYYY
Please read before submitting
I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
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