EMPLOYMENT APPLICATION Stambaugh Aviation

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of non-job related medical conditions or handicap, or any other legally protected status.

What position are you applying for?

Date: +

How did you learn about SA ?

Last Name *

First Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

SSN: *

If you are under 18, can you provide the required proof of your eligibility to work? *

Yes

No

Have you ever filed an application with us before? *

Yes

No

If Yes, Please give the date:

Have you ever been employed with us before? *

Yes

No

If Yes, Please give the date:

Are you currently employed? *

Yes

No

May we contact your present employer?

Yes

No

Are you prevented from lawfully becoming employed in this Country due to immigration or Visa status? (Proof of citizenship will be required upon employment) *

Yes

No

Are you currently on lay-off status and subject to recall? *

Yes

No

Can you travel should the job require it? *

Yes

No

Have you been convicted of a felony within the last several years? (Conviction will not necessarily disqualify an applicant for employment) *

Yes

No

If yes, please explain.

Are you legally authorized to work in the United States? *

Yes

No

Employment Experience

Employer 1

Employer 1:

Address

City, State, Zip:

Phone

Start Date +

End Date +

Job Title:

Starting Salary

Ending Salary

Supervisor/Manager

Duties Performed:

Reason for Leaving

May we contact?

Yes

No

Phone Number

Employer 2

Employer 2:

Address

City, State, Zip:

Phone

Start Date +

End Date +

Job Title:

Starting Salary

Final Salary

Supervisor/Manager

Duties performed:

Reason for Leaving

May we contact?

Yes

No

Phone Number

Employer 3

Employer 3

Address

City, State, Zip:

Phone

Start Date +

End Date: +

Job Title:

Starting Salary

Final Salary

Supervisor/Manager

Duties Performed:

Reason for Leaving

May we contact?

Yes

No

Phone Number

Upload Resume

Education

1) School Name & Location:

Grade Level:

Number Years Completed

Diploma/Degree Earned?

Course of Study?

2) School Name & Location:

Grade Level:

Number Years Completed

Diploma/Degree Earned?

Course of Study?

3) School Name & Location:

Grade Level:

Number Years Completed

Diploma/Degree Earned?

Course of Study?

4) School Name & Location:

Grade Level:

Number Years Completed

Diploma/Degree Earned?

Diploma/Degree Earned?

Please indicate any foreign languages you speak, read, or write

and your ability to do so

Language:

Speak:

Read:

Write:

Language:

Speak:

Read:

Write:

Military Service/Training

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

Yes

No

If Yes, please explain: Branch?

Type of Discharge:

Discharge Rank:

Duties:

Training:

Civilian Certification/Training

Please indicate FAA licenses held:

Aircraft Type:

40 Hour Formal Class Training:

Yes

No

40 Hour Certificate Received?

Yes

No

20 Hour Formal Class Training:

Yes

No

20 Hour Certificate Received?

Yes

No

Aircraft Type:

40 Hour Formal Class Training:

Yes

No

40 Hour Certificate Received?

Yes

No

20 Hour Formal Class Training:

Yes

No

20 Hour Certificate Received?

Yes

No

Aircraft Type:

40 Hour Formal Class Training:

Yes

No

40 Hour Certificate Received?

Yes

No

20 Hour Formal Class Training:

Yes

No

20 Hour Certificate Received?

Yes

No

Aircraft Type:

40 Hour Formal Class Training:

Yes

No

40 Hour Certificate Received?

Yes

No

20 Hour Formal Class Training:

Yes

No

20 Hour Certificate Received?

Yes

No

Aircraft Type:

40 Hour Formal Class Training:

Yes

No

40 Hour Certificate Received?

Yes

No

20 Hour Formal Class Training:

Yes

No

20 Hour Certificate Received?

Yes

No

Do you have copies of these certificates and others you received?

Yes

No

Do you have a copy of your on the job training file from your previous employer?

Yes

No

Are you physically or otherwise unable to perform the job you are applying for?

Yes

No

Special Skills Or Qualifications

Please summarize special job-related skills & qualifications you have acquired

References

Give name, address, phone number of three references who are not related to you

or previous employers

Reference 1

Reference 2

Referrence 3

Stambaugh Aviation is an Equal Opportunity Employer

Applicant's Statement

I herby certify and attest that the answers and information herein stated are true, accurate, and complete to the best of my knowledge.

I further authorize investigation by Stambaugh Aviation or their designated agent or representative, to investigate any and all statements or information in this application, as may be necessary, to arrive at an employment decision.

I acknowledge that SA is a Drug Free Workplace, as mandated by FAA & DOT Regulations, and that no employment offer is final until such time as I pass a drug screening as set forth and required by the FAA/DOT and failure of any screening will be at my sole responsibility and expense. In the event of failure, I will reimburse SA for all costs associated with, but not limited to, such testing (i.e. in processing etc.) I further acknowledge that should I feel a positive test result is in error, I may resubmit for testing at my own expense, once all costs have been reimbursed.

I understand that application of employment shall be considered active for a period of 6 months. In the event I desire to be considered for employment beyond this period, It will be necessary to inquire as to whether or not applications are being accepted at this time.

I further understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is an "AT WILL" nature, which means that any employee may resign at any time and SA may discharge any 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 specifically acknowledged in writing by Stambaugh Aviation.

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

Signature of Applicant (Use Mouse or Finger) *

clear

Date: * +

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