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InstallTech, Inc. Employment Application
For additional information, please email jobs@installtechinc.com or call 717-266-4002.
Resume Upload
If available, attache resume here:
 
Personal Information
E-Mail:*

First Name:*

Middle Initial

Last Name:*

Address Line 1:*

Address Line 2:

City:*

State:*

Zip Code:*

Cell Phone:*

Business Phone:

Home Phone:

Qualification Questions
Are you legaly authorized to work in the US?*
Yes No 

Do you have a valid driver*
Yes No 

Are you 18 years old or older?*
Yes No 

Are you able to pass a drug screening prior to starting employment?*
Yes No 

Do you have reliable transportation to and from work?*
Yes No 

Are you able to lift over 80 pounds 5-10 times during a day? (May not apply to all positions)*
Yes No 

Have you ever been charged with or convicted of a misdemeanor or felony?*
Yes No 

If yes, in what year?

Brief description of charges or conviction:

Work Preference
Date Available

Position Applied for:

Minimum Acceptable Salary:*

Employment Requested:*
Full Time Part Time Temporary 

Education
High School Name/Location:

Diploma Received:
Diploma
Equivalency
None

College Name/Location:

Degree Earned:

Attended from:

Attended To:

Major/Minor:

College Name/Location:

Degree Earned:

Attended from:

Attended To:

Major/Minor:

Employment History
Name Of Employer:*

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Employed From:

Employed To:

Employer Phone:

Job Title:

Supervisor Name:

Reason For Leaving:

Name Of Employer:

Address Line 1:

Address Line 2:

City:

State:

Zip Code:

Employed From:

Employed To:

Employer Phone:

Job Title:

Supervisor Name:

Reason For Leaving:

Skills Section
Related Knowledge/Skills:

Professional References
Please list three references that have knowledge of your professional experience.
Reference Name:*

Address:

Occupation:

Phone:

Reference Name:

Address:

Occupation:

Phone:

Reference Name:

Address:

Occupation:

Phone:

Disclaimer and e-Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Full Name*

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