Online Application
Please complete the following form and submit to our Human Resources Team. We will review and contact you at our earliest convenience. Contact us at info@burtins.com if you have any questions.
FIRST NAME: LAST NAME:
ADDRESS:
CITY | STATE | ZIP:
PHONE: ALTERNATE PHONE:
EMAIL ADDRESS: AVAILABLE DATE [MM/DD/YY]:
POSITION APPLYING FOR:
UTILITY CLEANER FLOOR TECHNICIAN LAWN & SNOW CREW
Have you ever applied at Burtin & Associates before?
YES NO
If so, when ?
Are you on lay-off or subject to recall?
YES NO
Are you a citizen of the United States?
YES NO
Do you have friends/relatives working here ?
YES NO
If so, please list.
Name:
Relationship:
Name:
Relationship:
Have you ever been convicted of a felony?
YES NO
If so, please explain ?
Education
SCHOOL NAME:
YEARS ATTENDED:
DIPLOMA:
HighSchool
YES
College / University
YES
Skill Training
YES
References
List three (3) references who are not related to you.
REFERENCE NAME:
ADDRESS:
PHONE:
YEARS:
Employment History
Please list each job held begining with current or most recent.
Company Name:
Phone:
Address| City/State/Zip:
Supervisor's Name:
Position Held:
Date Hired:
Last Day Worked :
Salary:
Reason for Leaving :
Company Name:
Phone:
Address| City/State/Zip:
Supervisor's Name:
Position Held:
Date Hired:
Last Day Worked :
Salary:
Reason for Leaving :
Company Name:
Phone:
Address| City/State/Zip:
Supervisor's Name:
Position Held:
Date Hired:
Last Day Worked :
Salary:
Reason for Leaving :
 
COMMENTS & ADDITIONAL INFORMATION:
SUBMIT FORM
 
CLICK HERE
FOR PRINTED APPLICATION:
   
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