Piedmont Environmental
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Employment

INSPECTION

REMEDIATION

PREVENTION

WATER DAMAGE

FIRE DAMAGE

DUCT CLEANING


Piedmont Environmental, Mold Inspection and Remediation Services, A Full Service Mold and Moisture Removal Company


CRMI - AmIAQ - # 13692
CMRC - MICRO - # 06-2158
Virginia Contractors License -
# 2705109527
Licensed Building Inspector -
# 3380 000348



 Personal Information      * Required Fields
How were you referred:
 Available Positions
(Please Choose)
Position 1 - Remediation Techs
Position 2 - Duct Cleaning Techs Position 3 - Outside Sales

 
* Full Name:
* Address:
* City:
* State:
* Zip:
* Your E-mail:
* Phone:
Mobile/Other:
* 18 Years Or Older:
* Valid Drivers License?
* Date You Can Start:
* Salary Expectations:
* Citizen - United States?
* If NO, legally allowed?
* Type of employment:


* Ever been convicted ?
* If YES, give dates/details:
Answering "yes" to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

Summarize Your Special Skills or Qualifications:
   
   Previous Employment (begin with most recent position):
Dates of Employment: From:   To:   
Positions(s) Held:
Firm / Company: 
Address of Employer:  
Phone Number:  
Supervisor:  
Title of Supervisor:  
Your Responsibilities:  
Starting Salary & Title:  
Ending Salary and Title:  
Reason for Leaving:  
May we contact this employer for reference ? Yes     No  
   
   Previous Employment
Dates of Employment: From:   To:   
Positions(s) Held:
Firm / Company: 
Address of Employer:  
Phone Number:  
Supervisor:  
Title of Supervisor:  
Your Responsibilities:  
Starting Salary & Title:  
Ending Salary and Title:  
Reason for Leaving:  
May we contact this employer for reference ? Yes     No  
   
   Previous Employment
Dates of Employment: From:   To:   
Positions(s) Held:
Firm / Company: 
Address of Employer:  
Phone Number:  
Supervisor:  
Title of Supervisor:  
Your Responsibilities:  
Starting Salary & Title:  
Ending Salary and Title:  
Reason for Leaving:  
May we contact this employer for reference ? Yes     No  
   


APPLICANT'S STATEMENT

AUTHORIZATION

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information giving in my application or interviews(s) may result in discharge.

 


I agree to the AUTHORIZATION

      

 

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